Anti-interleukin-17 and anti-interleukin-23 biologic drugs for genital psoriasis: a single-center retrospective comparative study

Andrea Cortese; Luigi Gargiulo; Luciano Ibba; Giovanni Fiorillo; Francesco Toso; Carlo Alberto Vignoli; Alessandra Narcisi; Antonio Costanzo; Mario Valenti

doi:10.4081/dr.2023.9692

Authors

Andrea Cortese
andrea.cortese@humanitas.it
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele; Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy. https://orcid.org/0000-0001-9500-444X
Luigi Gargiulo Department of Biomedical Sciences, Humanitas University, Pieve Emanuele; Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy. https://orcid.org/0000-0002-6051-1676
Luciano Ibba Department of Biomedical Sciences, Humanitas University, Pieve Emanuele; Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy. https://orcid.org/0000-0002-7876-4866
Giovanni Fiorillo Department of Biomedical Sciences, Humanitas University, Pieve Emanuele; Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy. https://orcid.org/0000-0002-3089-4362
Francesco Toso Department of Biomedical Sciences, Humanitas University, Pieve Emanuele; Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy. https://orcid.org/0000-0001-8531-5164
Carlo Alberto Vignoli Department of Biomedical Sciences, Humanitas University, Pieve Emanuele; Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.
Alessandra Narcisi Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.
Antonio Costanzo Department of Biomedical Sciences, Humanitas University, Pieve Emanuele; Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.
Mario Valenti Department of Biomedical Sciences, Humanitas University, Pieve Emanuele; Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy. https://orcid.org/0000-0001-9140-9263

Genital psoriasis affects 3-33% of patients with psoriasis during the course of the disease, usually leading to a severe reduction in the patient’s quality of life. This study aims to retrospectively assess the effectiveness of interleukin (IL)-23 and IL-17 inhibitors in a real-life population affected by moderate-to-severe plaque psoriasis with genital involvement coming from our dermatology department. A total of 86 patients with a diagnosis of moderate-tosevere plaque psoriasis with severe genital involvement were enrolled. Patient characteristics, psoriasis area and severity index (PASI), and static physician global assessment of genitalia (sPGAG) at each visit were recorded. During the treatment, the mean PASI decreased from 12.8 to 0.63 at week 52; a PGA of 0/1 was reached by 97.40% at week 52 and by 100% of patients (37/37) at week 104. No significant differences between IL-23 and IL-17 inhibitors were observed; indeed, the bio-naïve group of patients demonstrated a superior response compared to the group of bioexperienced patients.Our findings confirmed that IL-23 and IL-17 inhibitors are safe and effective therapeutic options for the treatment of genital psoriasis.

Boehncke WH, Schön MP. Psoriasis. Lancet 2015;386:983-94.

Narcisi A, Valenti M, Cortese A, et al. Anti-IL17 and anti-IL23 biologic drugs for scalp psoriasis: a single-center retrospective comparative study. Dermatol Ther 2022;35:e15228.

Meeuwis KAP, Potts Bleakman A, van de Kerkhof PCM, et al. Prevalence of genital psoriasis in patients with psoriasis. J Dermatolog Treat 2018;29:754-60.

Kelly A, Ryan C. Genital psoriasis: impact on quality of life and treatment options. Am J Clin Dermatol 2019;20:639-46.

Duarte GV, Calmon H, Radel G, de Fátima Paim de Oliveira M. Psoriasis and sexual dysfunction: links, risks, and management challenges. Psoriasis (Auckl) 2018;8:93-9.

Kaushik SB, Lebwohl MG. Review of safety and efficacy of approved systemic psoriasis therapies. Int J Dermatol 2019;58:649-58.

Hong JJ, Mosca ML, Hadeler EK, et al. Genital and inverse/intertriginous psoriasis: an updated review of therapies and recommendations for practical management. Dermatol Ther (Heidelb) 2021;11:833-44.

Gisondi P, Fargnoli MC, Amerio P, et al. Italian adaptation of EuroGuiDerm guideline on the systemic treatment of chronic plaque psoriasis. Ital J Dermatol Venerol 2022;157:1-78.

Merola JF, Bleakman AP, Gottlieb AB, et al. The static physician's global assessment of genitalia: a clinical outcome measure for the severity of genital psoriasis. J Drugs Dermatol 2017;16:793-9.

Guenther L, Potts Bleakman A, Weisman J, et al. Ixekizumab results in persistent clinical improvement in moderate-to-severe genital psoriasis during a 52 week, randomized, placebo-controlled, phase 3 clinical trial. Acta Derm Venereol 2020;100:adv00006.

Yosipovitch G, Foley P, Ryan C, et al. Ixekizumab improved patient-reported genital psoriasis symptoms and impact of symptoms on sexual activity vs placebo in a randomized, double-blind study. J Sex Med 2018;15:1645-52.

Almutairi N, Eassa BI. A randomized controlled ixekizumab vs secukinumab trial to study the impact on sexual activity in adult patients with genital psoriasis. Expert Opin Biol Ther 2021;21:297-8.

Narcisi A, Valenti M, Gargiulo L, et al. Real-life effectiveness of tildrakizumab in chronic plaque psoriasis: a 52-week multicentre retrospective study-IL PSO (Italian landscape psoriasis). J Eur Acad Dermatol Venereol 2023;37:93-103.

Gargiulo L, Ibba L, Pavia G, et al. Real-life effectiveness and safety of risankizumab in 131 patients affected by moderate-to-severe plaque psoriasis: a 52-week retrospective study. Dermatol Ther (Heidelb) 2022;12:2309-24.

Hsu L, Armstrong AW. Anti-drug antibodies in psoriasis: a critical evaluation of clinical significance and impact on treatment response. Expert Rev Clin Immunol 2013;9:949-58.

Cortese, A., Gargiulo, L., Ibba, L., Fiorillo, G., Toso, F., Vignoli, C. A., Narcisi, A., Costanzo, A., & Valenti, M. (2023). Anti-interleukin-17 and anti-interleukin-23 biologic drugs for genital psoriasis: a single-center retrospective comparative study. Dermatology Reports, 15(3). https://doi.org/10.4081/dr.2023.9692