Comparison of two new treatments for psoriasis

Linked Article:   Blauvelt et al. Br J Dermatol 2021; 184 :1047–1058. Psoriasis is a skin disease that affects about 125 million people worldwide, causing scaly and itchy patches of skin all over the body. One‐quarter of people with psoriasis also have nail psoriasis, which causes abnormally coloured and misshapen nails. As well as causing decreased quality of life, more widespread psoriasis often affects internal health. New drugs like ixekizumab (IXE) and guselkumab (GUS) have been developed in the last few years. They work differently from each other in the body and have been recently tested directly against each other. In a previous article showing results from the first part of this study, the authors found that significantly more patients treated with IXE can achieve completely clear skin after 3 months compared with GUS, and IXE worked more rapidly than GUS. In the second part of this study, presented in the current report, researchers from the USA and Canada measured how many patients achieved complete clearance of skin and nail psoriasis 24 weeks (about 6 months) after starting either IXE or GUS. At 24 weeks, IXE and GUS treatment resulted in completely clear skin in similar numbers of patients (50% of people who took IXE and 52% of people who took GUS). However, more patients with nail psoriasis who took IXE had completely clear nails (63% of people who took IXE and 44% of people who took GUS). To measure how quickly patients got better, the authors calculated the time it took for 50% of patients on IXE or GUS to reach completely clear skin. They found that the group receiving IXE achieved the 50% mark 7·5 weeks sooner than the GUS group. Itching and quality of life also improved faster with IXE. The percentage of patients who had serious side‐effects was 3% for both groups. Overall, people with psoriasis who take IXE may get clear skin and nails and feel better faster than people who take GUS.