A Systematic Review with Meta-Analysis of Comparative Efficacy and Safety of Risankizumab and Ustekinumab for Psoriasis Treatment

Abstract

Biological targeted therapy serves as a new alternative treatment for psoriasis due to its minimal side effects. This study is aimed at examining the drug effectiveness and safety of risankizumab and ustekinumab for psoriasis treatment, so as to provide a reference for clinical decision-making. Databases from Embase, Web of Science, PubMed, and Cochrane Library were gathered, starting from inception to March 1, 2022, for randomized controlled trials regarding risankizumab and ustekinumab for psoriasis treatment. All retrieved articles were carefully selected in strict accordance with a set of inclusion and exclusion criteria. Stata 15.0 and RevMan 5.4 were applied to perform meta-analysis and risk of bias assessment. A total of two trials with three NCTs were selected, with 384 participants in the risankizumab group and 140 participants in ustekinumab. Meta-analysis showed that in the long-term and short-term PASI100, risankizumab was more effective than ustekinumab ( RR = 2.27 , 95% CI (1.77, 2.90), p < 0.05 ; RR = 2.33 , 95% CI (1.75, 3.08), p < 0.05 ). In PASI90, RR = 1.77 , 95% CI (1.54, 2.03), and p < 0.05 and RR = 1.72 , 95% CI (1.48, 2.00), and p < 0.05 . In short-term PASI75, RR = 1.23 , 95% CI (1.13, 1.34), and p < 0.05 . In sPGA of 0, the results at week-16 and week-52 showed that risankizumab was significantly more effective than ustekinumab ( RR = 2.24 , 95% CI (1.67, 3.01), p < 0.05 ; RR = 2.30 , 95% CI (1.80, 2.95), p < 0.05 ). Risankizumab was significantly more effective than ustekinumab in improving the quality of life and PSS scores ( RR = 1.48 , 95% CI (1.26, 1.75), p < 0.05 ; RR = 2.01 , 95% CI (1.41, 2.85), p < 0.05 ). Nevertheless, risankizumab and ustekinumab did not show significant difference in the incidence of adverse responses ( RR = 1.02 , 95% CI (0.75, 1.39), p > 0.05 ). Risankizumab was more effective than ustekinumab for the treatment of psoriasis. The adverse reactions of both risankizumab and ustekinumab were similar and could be tolerated. Risankizumab might be a better alternative option for their treatment.

Comparing Meta-Analyses with ChatGPT in the Evaluation of the Effectiveness and Tolerance of Systemic Therapies in Moderate-to-Severe Plaque Psoriasis

“…We identified 28 MAs/NMAs published between January 2021 and May 2023, investigating and comparing the effect of systemic therapies for moderate-to-severe adult plaque psoriasis [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. A total of 10 analyses were excluded for the following reasons: insufficient information on the compared therapies in the abstract, the absence of the full text [ 28 , 29 , 30 ], the full text being in a language other than English [ 31 ], being a comparison to a placebo [ 32 , 33 , 34 , 35 , 36 ], or the absence of a direct comparison between therapies [ 37 ].…”

“…The safety of the molecules was compared in two MAs [ 13 , 23 ] and two NMAs [ 18 , 21 ]. Although one meta-analysis indicated that risankizumab was better tolerated than infliximab, ChatGPT’s output was rated as different, as the AI estimated that these two drugs had a similar safety profile.…”

“…There were, however, some discrepancies between the conclusions of the NMAs and the answers of ChatGPT when several molecules were compared. For instance, although for the majority of the recently published NMAs, ixekizumab and risankizumab [ 13 , 15 , 16 , 17 , 18 , 21 ] outperformed most biologics in the long-term, secukinumab and guselkumab sometimes ranked as high as ixekizumab and risankizumab in some of ChatGPT’s answers. The choice of reformulating queries or sending them at another timeframe to obtain more detailed answers, although debatable, was deliberate, as the comparisons would have been made impossible if we selected only vague, general outputs.…”

Adalimumab, Ustekinumab, and Secukinumab in the Management of Hidradenitis Suppurativa: A Review of the Real-Life Experience

“…FDA approval is indicated for use in moderate to severe plaque psoriasis (Ps) for patients 6 years of age and older. 48 , 49 Main articles regarding the use of ustekinumab for the management of hidradenitis suppurativa in real-life setting are reported in Table 2 .…”

The Role of IL-23 Inhibitors in Crohn’s Disease

“…The second generation of selective anti-IL-23 therapies targets IL-23p19, and they have demonstrated greater effectiveness compared to ustekinumab in treating other immune-mediated conditions, such as plaque psoriasis, prompting us to explore their potential use in IBD [ 19 , 20 ].…”