Tuberculosis (TB) remains a significant global health issue, especially for individuals with latent tuberculosis infection (LTBI). Current evidence suggests that IL-17 and IL-23 inhibitors, used to treat conditions like psoriasis, do not increase the risk of TB reactivation. This study aimed to assess the safety of these inhibitors in psoriasis patients with newly diagnosed LTBI, evaluating the risk of TB reactivation and the tolerability of chemoprophylaxis.

In a retrospective study of 405 psoriasis patients across multiple countries, 62.2% received complete chemoprophylaxis, while 27.7% did not due to concerns about liver toxicity. The average treatment duration was about 33 months, and only one case of active TB occurred, specifically in a patient treated with ixekizumab. The overall TB reactivation risk for IL-17 inhibitors was 0.46%, with no cases observed for IL-23 inhibitors. These findings suggest that IL-17 and IL-23 inhibitors do not significantly increase TB reactivation risk, and they may be preferred over TNF antagonists when TB concerns exist, especially for patients at high risk of chemoprophylaxis-related complications.

Reference: Torres T, Chiricozzi A, Puig L, et al. Treatment of Psoriasis Patients with Latent Tuberculosis Using IL-17 and IL-23 Inhibitors: A Retrospective, Multinational, Multicentre Study. Am J Clin Dermatol. 2024 Mar;25(2):333-342. doi: 10.1007/s40257-024-00845-4.