Does p40‐targeted therapy represent a significant evolution in the management of plaque psoriasis?

The recognition of the roles of interleukins (IL)‐12 and IL‐23 in the development of psoriasis is an important advance in the understanding, and the subsequent management, of this chronic inflammatory disease. Two human anti‐p40 monoclonal antibodies targeting both IL‐12 and IL‐23 via their shared p40 subunit have been developed: briakinumab and ustekinumab. Recent Phase 2 and Phase 3 trials have illustrated the benefits of briakinumab (in Phase 3 clinical development) and ustekinumab (approved in the EU, and also in other territories worldwide) in the treatment of moderate to severe plaque psoriasis. Available data indicate that a strategy targeting the IL‐12 p40 subunit has considerable advantages over targeting of tumour necrosis factor‐α, offering rapid onset of efficacy with a favourable dosing regimen (every 12 weeks for ustekinumab). Registries incorporating rigorous pharmacovigilance are now required to further understand the clinical profile of these drugs over long‐term use.