Evidence mapPaperPMID 40439435Full record

ArticleJournal of the European Academy of Dermatology and Venereology : JEADV2025

Drug survival of IL-23 and IL-17 inhibitors versus other biologics for psoriasis: A British Association of Dermatologists Biologics and Immunomodulators Register cohort study.

Leila Motedayen Aval, Zenas Z N Yiu, Oras A Alabas, Christopher E M Griffiths, Nick J Reynolds, Philip J Hampton, Catherine H Smith, Richard B Warren, BADBIR Study Group

Abstract readComparative Study
In one paragraph

Article in Journal of the European Academy of Dermatology and Venereology : JEADV, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 2 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Article
  7. Medicina (Kaunas, Lithuania) · 2026
    Observational
  8. Review
  9. Differential clinical factors influencing the effectiveness of distinct biologic agents in psoriasis: insights from a prospective cohort study in China.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2026
    Observational
  10. Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. IL-23 Inhibitors in Psoriasis: What Have We Learnt so Far?Journal of inflammation research · 2026
    Review
  16. Article
  17. Article
  18. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Leila Motedayen AvalDivision of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, The Dermatology Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.ORCID https://orcid.org/0009-0005-7352-6454
Zenas Z N YiuDivision of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, The Dermatology Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.ORCID https://orcid.org/0000-0002-1831-074X
Oras A AlabasDivision of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, The Dermatology Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.ORCID https://orcid.org/0000-0003-2002-0781
Christopher E M GriffithsDivision of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, The Dermatology Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.ORCID https://orcid.org/0000-0001-5371-4427
Nick J ReynoldsDepartment of Dermatology, Royal Victoria Infirmary and NIHR Newcastle Biomedical Research Centre, Newcastle Hospitals NHS Foundation Trust, Institute of Translational and Clinical Medicine, Medical School, Newcastle University, Newcastle upon Tyne, UK.
Philip J HamptonDepartment of Dermatology, Royal Victoria Infirmary and NIHR Newcastle Biomedical Research Centre, Newcastle Hospitals NHS Foundation Trust, Institute of Translational and Clinical Medicine, Medical School, Newcastle University, Newcastle upon Tyne, UK.
Catherine H SmithSt John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, and King's College London, London, UK.ORCID https://orcid.org/0000-0001-9918-1144
Richard B WarrenDivision of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, The Dermatology Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
BADBIR Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInterleukin (IL)-23p19 and IL-17 inhibitors have demonstrated high efficacy for psoriasis in randomized controlled trials, though real-world data, particularly for risankizumab (IL-23p19 inhibitor) and brodalumab (IL-17 receptor (IL-17R) inhibitor), is limited.

objectivesTo assess drug survival of IL-23p19 and IL-17 inhibitors compared to other biologics for psoriasis.

methodsWe conducted a cohort study using data from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR) from November 2007 to June 2023. Multivariable flexible parametric models assessed drug survival, with discontinuation due to ineffectiveness and adverse effects reported separately. The primary outcome measure was the absolute difference in restricted mean survival time at 2 years, referred to as adjusted survival time, between all comparators.

resultsAmong 19,034 treatment courses (median follow-up: 2.3 years), treatments included adalimumab (tumour necrosis factor-alpha (TNF-a) inhibitor, n = 6,815), ustekinumab (IL-12/23p40 inhibitor, n = 5,639), secukinumab (IL-17A inhibitor, n = 3,051), ixekizumab (IL-17A inhibitor, n = 1,072), brodalumab (n = 367), guselkumab (IL-23p19 inhibitor, n = 1,258) and risankizumab (n = 832). Guselkumab and risankizumab had the highest adjusted survival times (years [interquartile ranges]) for effectiveness (1.93 [1.91-1.95] and 1.93 [1.90-1.96], respectively). Risankizumab had the highest survival for safety (1.94 [1.92-1.96]) followed by guselkumab (1.92 [1.90-1.94]) and ustekinumab (1.92 [1.91-1.93]). Brodalumab showed lower adjusted survival time for effectiveness (1.75 [1.69-1.81]) than most biologics except secukinumab and adalimumab; and similar survival for safety (1.85 [1.81-1.90]) compared to IL-17A inhibitors and adalimumab. In patients with psoriatic arthritis, ustekinumab showed reduced drug survival. Prior biologic exposure was associated with a dose-response reduction in survival which was significantly larger for IL-17 inhibitors.

conclusionsGuselkumab and risankizumab have the most favourable drug survival for effectiveness, with comparable safety to ustekinumab, and more favourable than other BADBIR biologics. Longer drug survival may reduce treatment burden by minimizing treatment switches, clinic visits and disease flares, supporting IL-23p19 inhibitors as a practical long-term option for psoriasis.

Indexed as

Biological ProductsDermatologic AgentsInterleukin-17Interleukin-23Interleukin-23 Subunit p19PsoriasisAdalimumabAdultAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedCohort StudiesFemaleHumansMaleMiddle AgedRegistriesAdalimumabAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedBiological ProductsbrodalumabDermatologic AgentsguselkumabInterleukin-17Interleukin-23Interleukin-23 Subunit p19ixekizumabrisankizumabsecukinumabUstekinumab

Identifiers

PMID40439435
PMCPMC12466084

What Socratic holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.