IL-23 inhibition for the treatment of psoriatic arthritis

Raagav Mohanakrishnan, Secia Beier, Atul Deodhar

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations


Introduction: Psoriatic arthritis (PsA) is a complex, polygenic immune-mediated disease with varying clinical presentations involving the skin, nails, entheses, and axial/peripheral skeleton. Areas covered: Pathophysiology of PsA with special focus on IL-23/IL-17 axis. Novel classes of targeted therapies for PsA. Pharmacologic properties, efficacy and safety of guselkumab, the only FDA approved agent from IL-23p19 inhibitor class. Data regarding other IL-23 inhibitors (Ustekinumab–an IL-12/IL-23p40 inhibitor, Risankizumab and Tildrakizumab–both IL23p19 inhibitors), in the treatment of PsA. Expert opinion: There are seven classes of FDA-approved therapies for the treatment of PsA. IL-23p19 inhibitors are the newest class of medications that has shown efficacy and reasonable safety profile in the treatment of PsA in phase 2 and phase 3 studies; Guselkumab is the only FDA-approved biologic for PsA within this class. While no head-to-head studies of IL-23p19 inhibitors and other PsA targeted therapies are available, the efficacy of these agents on musculoskeletal system appears to be comparable to TNF-inhibitors (TNFi), and the efficacy on the skin appears to be comparable, or modestly superior to the IL-17 inhibitors (IL-17i). With a superior safety profile compared to TNFi and IL-17i, IL-23p19 inhibitors have the potential to become a first-line biologic in the treatment of PsA.

Original languageEnglish (US)
Pages (from-to)59-65
Number of pages7
JournalExpert Opinion on Biological Therapy
Issue number1
StatePublished - 2022


  • IL-23
  • Psoriatic arthritis
  • guselkumab
  • interleukin-23
  • risankizumab
  • ustekinumab

ASJC Scopus subject areas

  • Pharmacology
  • Drug Discovery
  • Clinical Biochemistry


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