Anti-IL17 and anti-IL23 biologic drugs for scalp psoriasis: A single-center retrospective comparative study

Scalp is a frequent localization of psoriasis that has a massive impact on patient's quality of life. Managing this psoriasis' manifestation is often challenging, thus biologic drugs are widely used as a treatment option in refractory scalp psoriasis. The aim of our study is to retrospectively compare the efficacy of anti-interleukin (IL) 23 drugs (guselkumab, tildrakizumab, risankizumab) and anti-IL17 or anti-IL17RA biologics (secukinumab, ixekizumab, and brodalumab) in real-life patients affected by scalp psoriasis. One hundred twenty-seven patients with a clinical diagnosis of scalp psoriasis and a baseline scalp Physician Global Assessment ≥3 were enrolled; 65 patients were treated with anti-IL23 and anti-IL62 with anti-IL17 or anti-IL17RA. Statistical analysis trough χ² test was performed in order to evaluate the percentage of response among the two groups of patients. Responders' percentage of patients under anti-IL23 was 41.5%, 75.4%, 88.1%, 87.5%, 93.7%, and 100% at Week 4, 16, 48, 96, and 144, respectively. In the group on anti-IL17 was 62.9%, 90.3%, 91.2%, 97.3%, 96.9%, and 95.2% at Week 4, 16, 48, 96, and 144, respectively. Both anti-IL17 and anti-IL23 appeared to be effective on scalp psoriasis; in particular patients treated with anti-IL17 drugs reached a faster significant reduction of the lesions; on the other hand, anti-IL23 monoclonal antibodies were slightly superior in maintaining the clinical improvement through the follow-up.