This single-center retrospective cohort study was carried out to indirectly compare the tolerability, efficacy, and safety of guselkumab and risankizumab (interleukin-23 inhibitors) for psoriasis management in real world practice.

The study recruited 68 people suffering from psoriasis. Participants were managed with either a standard dose of guselkumab (n=36; 100 mg given by subcutaneous injection at week 0 and week four, followed by a maintenance dose every eight weeks) or with a standard dose of risankizumab (n=32; two injections of 75 mg subcutaneously at week 0, week four, and then every twelve weeks).

The study groups were found to be comparable for all the evaluated characteristics, except for the mean psoriasis duration that was greater for guselkumab. Table 1 shows a decline in mean Psoriasis Area and Severity Index (PASI) at the baseline, week 28 and week 44.

No inter-group profound differences were noted in mean PASI and body surface area. In both guselkumab and risankizumab groups, no cases of severe adverse events, cardiovascular events, injection site reaction, malignancy, and candida were noted.

In real world practice, both risankizumab and guselkumab demonstrated favorable efficacy and safety profile, being comparable in terms of PASI100 and PASI90 responses as well as in the frequency of adverse events and discontinuation rates.