Efficacy and drug survival after transitioning to IL-17 inhibitors in patients with psoriasis who did not respond to IL-23 inhibitors: analysis from the BIOREP registry

INTRODUCTION: Switching biologics for psoriasis is common; however, data on switching to alternative treatments after failure of IL-23 inhibitors are limited. METHODS: A retrospective analysis was conducted to extract efficacy and drug survival data from the BIOREP registry from January 2015 to June 2025. The analysis included all patients with psoriasis who were switched from an IL-23 inhibitor to an IL-17 inhibitor during this period and had at least one follow-up visit recorded. RESULTS: A total of 102 patients were switched from an IL-23 inhibitor to an IL-17 inhibitor, with 92 (90.2%) of these switches occurring due to insufficient efficacy. In these 92 patients, PASI-75 was achieved in 82.6% after 3 months and in 73.5% after 12 months. Absolute PASI ≤ 1 was achieved by 66.3% of patients after 3 months and 52.9% after 12 months. Patients treated with bimekizumab had the highest probability of meeting both efficacy parameters, particularly an absolute PASI ≤ 1 after 3 months. The overall survival probability was 79.5% after 12 months and 68.1% after 24 months. CONCLUSION: For patients with an inadequate response to IL-23 inhibitors, switching to IL-17 inhibitors offers adequate efficacy in reaching current therapeutic goals during the first year of treatment.