Various systemic therapies are available for the treatment of plaque psoriasis, each with distinct mechanisms of action. The objective of this analysis was to compare the time to onset of action among these treatments by assessing the time required for patients to achieve meaningful clinical responses (PASI75 and PASI90). The study included randomized controlled trials comparing two or more systemic therapies for moderate to severe plaque psoriasis. A weighted average time to achieve PASI75 (75% improvement in Psoriasis Area and Severity Index) and PASI90 (90% improvement) was calculated for each therapy. A network meta-analysis was conducted to determine which treatments had the fastest onset of meaningful clinical response.

IL-17 inhibitors were found to have the shortest time to achieve PASI75 and PASI90, with risankizumab following closely in the weighted mean analysis. In the meta-analysis, bimekizumab, brodalumab, and ixekizumab showed the fastest time to PASI75, with bimekizumab demonstrating a significantly faster time compared to the other treatments. For PASI90, ixekizumab, bimekizumab, risankizumab, secukinumab, and guselkumab had the quickest onset, with bimekizumab again showing the fastest response compared to other therapies. IL-17 and IL-23 inhibitors are among the fastest therapies to achieve meaningful clinical responses in plaque psoriasis. However, when choosing a treatment, clinicians should also consider the safety profiles of these drugs in addition to their speed of action.

Reference: Aggarwal P, Fleischer AB Jr. IL-17 and IL-23 Inhibitors Have the Fastest Time to Meaningful Clinical Response for Plaque Psoriasis: A Network Meta-Analysis. Journal of Clinical Medicine. 2024; 13(17):5139. https://doi.org/10.3390/jcm13175139