| Summary: | With the recent advancements of biologic therapies that block IL-23, there is increasing need for analysis of which biologics are most efficacious in treatment of plaque psoriasis. Guselkumab and risankizumab have each individually been compared to adalimumab in head-to-head trials, but no prior clinical trials have directly compared them to each other. The authors performed a literature review of guselkumab and risankizumab to determine which treatment is more efficacious in the management of plaque psoriasis. Using PubMed, a literature review was conducted using the terms “adalimumab psoriasis”, “risankizumab psoriasis”, and “guselkumab psoriasis”. Fifteen studies resulted, and all were nonduplicate clinical trials written in English that were conducted within the past 5 years and included plaque psoriasis in the title. The data supports that risankizumab is more effective in improving Dermatology Life Quality Index (DLQI), static Physician’s Global Assessment (sPGA), and Psoriasis Area and Severity Index (PASI) 90 scores. However, risankizumab may be associated with more adverse events than guselkumab. Major limitations of this review include that only one prior head-to-head trial comparing risankizumab to adalimumab has been conducted and there are no Phase II studies comparing the two biologics. Furthermore, risankizumab is a recently approved treatment and data regarding long-term efficacy and side effects are limited. Risankizumab and guselkumab are both highly effective, very safe, and very convenient psoriasis treatments that can be considered first-line treatment options for patients with moderate-to-severe plaque psoriasis.
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