medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-033medsovet-7387Research ArticleЗАБОЛЕВАНИЯ КОЖИDERMAL DISEASESВозможность применения моноклональных антител к интерлейкину 23 в терапии тяжелого псориаза при ускользании эффекта генно-инженерных биологических препаратовThe feasibility of the use of monoclonal antibodies to interleukin 23 in the therapy of severe psoriasis with the eluding effect of genetically engineered biological drugshttps://orcid.org/0000-0001-5723-6573ЖуковаО. В.ZhukovaO. V.

Жукова Ольга Валентиновна, д.м.н., профессор, заведующая кафедрой дерматовенерологии и аллергологии с курсом иммунологии Медицинского института; главный врач 

 117198, Россия, Москва, ул. Миклухо-Маклая, д. 6 

 119071, Россия, Москва, Ленинский проспект, д. 17 

Olga V. Zhukova, Dr. Sci. (Med.), Professor, Head of the Department of Dermatovenereology and Allergology with the Course of Immunology,Medicine Institute; Chief Medical Officer

6, Miklukho-Maklai St., Moscow, 117198, Russia

17, Leninskiy Ave., Moscow, 119071, Russia 

klinderma@inbox.ruhttps://orcid.org/0000-0002-2793-8862АртемьеваС. И.ArtemyevaS. I.

Артемьева Софья Иосифовна, младший научный сотрудник отдела клинической дерматовенерологии и косметологии, врач-дерматовенеролог

119071, Россия, Москва, Ленинский проспект, д. 17

Sofya I. Artemyeva, Junior Researcher, Department of Clinical Dermatovenereology and Cosmetology, Dermatovenereologist

17, Leninskiy Ave., Moscow, 119071, Russia 

sofya.chern@gmail.comhttps://orcid.org/0000-0001-5842-9772Аль-ХаватмиА.А.-Х. М.Al-HawatmiA.A.-H. M.

Аль-Хаватми Ахмад Абдель-Хамид Махмуд, аспирант кафедры дерматовенерологии и аллергологии с курсом иммунологии Медицинского института 

117198, Россия, Москва, ул. Миклухо-Маклая, д. 6 

Ahmad A.-H.M. Al-Hawatmi, Postgraduate Student, Department of Dermatovenereology and Allergology with the Course of Immunology,Medicine Institute

6, Miklukho-Maklai St., Moscow, 117198, Russia 

ahmad-hawatma@mail.ruРоссийский университет дружбы народов; Московский научно-практический центр дерматовенерологии и косметологииРоссияPeoples’ Friendship University of Russia; Moscow Scientific and Practical Center of Dermatovenereology and CosmetologyRussian FederationМосковский научно-практический центр дерматовенерологии и косметологииРоссияMoscow Scientific and Practical Center of Dermatovenereology and CosmetologyRussian FederationРоссийский университет дружбы народовРоссияPeoples’ Friendship University of RussiaRussian Federation202315032023024652Copyright © Жукова О.В., Артемьева С.И., Аль-Хаватми А.М., 20232023Жукова О.В., Артемьева С.И., Аль-Хаватми А.М.Zhukova O.V., Artemyeva S.I., Al-Hawatmi A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7387

Псориатическая болезнь представляет собой заболевание, характеризующееся развитием прогрессирующего хронического воспалительного процесса, вызванного различными иммунологическими путями, среди которых ключевую роль играет ось IL-23 – Th17. По этой причине в настоящее время активно изучается эффективность применения ингибиторов IL-23 p19. На сегодняшний день для лечения псориаза существует достаточно большое количество терапевтических опций среди генно-инженерных биологических препаратов (ГИБП), однако в реальной клинической практике пациенты могут терять эффективность или страдать от нежелательных явлений, что приводит к необходимости переключения на другие классы ГИБП. Гуселькумаб – полностью человеческое моноклональное антитело типа IgG1λ, которое селективно связывается с субъединицей p19 интерлейкина 23 (IL-23) с высокой специфичностью и аффинностью. Внедрение препарата в клиническую практику позволило повысить уровень эффективности, безопасности и выживаемости генно-инженерной биологической терапии псориаза. Задача практикующих клиницистов – найти оптимальные подходы к лечению псориатической болезни, исходя из анализа данных клинических исследований и реальной практики. Однако актуальной проблемой является отсутствие достаточной информации о применении препарата гуселькумаб в реальной клинической практике в случае его инициации после применения других классов ГИБП – анти-ФНО-α, анти-IL-17 и (или) анти-IL-12/23. В статье приведен обзор существующих литературных данных, а также собственные клинические наблюдения небионаивных пациентов с успешным переключением терапии на ингибитор IL-23 гуселькумаб. Понимание основных аспектов терапии псориаза ГИБП позволит достичь успешного контроля над заболеванием и повысить качество жизни пациентов в целом.

Psoriatic disease is a condition characterised by the development of a progressive chronic inflammatory process caused by various immunological pathways, among which the IL-23/Th17 axis plays a key role. Therefore, the efficacy of IL-23 p19 inhibitors is currently being actively studied. To date, quite a large number of therapeutic options among genetically engineered biological drugs (GEBDs) exist for the treatment of psoriasis, but in real clinical practice patients may lose efficacy or suffer from adverse events, resulting in the need to switch to other classes of GEBDs. Guselkumab is a fully human IgG1λ monoclonal antibody that binds selectively to the p19 subunit of interleukin 23 (IL-23) with high specificity and affinity. The implementation of the drug into clinical practice has improved the efficacy, safety and survival rate of genetically engineered biological therapy for psoriasis. Finding optimal approaches to the treatment of psoriatic disease by analysing data from clinical trials and actual practice is the real challenge for practicing clinicians. However, a current problem is the lack of sufficient information on the use of guselkumab in real clinical practice when it is initiated subsequent to administration of other classes of GEBDs – anti-TNF-α, anti-IL-17 and/or anti-IL-12/23. This article provides a review of the existing literature, as well as our own clinical observations of non-bionaive patients with successful therapy switching to the IL-23 inhibitor guselkumab. Understanding the basic aspects of GEBD therapy for psoriasis will help to achieve successful control of the disease and improve the quality of life of patients in general.

псориазгуселькумабгенно-инженерная биологическая терапияингибиторы интерлейкина 23psoriasisguselkumabgenetically engineered biologic therapyinterleukin 23 inhibitorsReferencesMichelucci A., Manzo Margiotta F., Panduri S., Tonini A., Romanelli M., Morganti R. et al. A real-life experience as a proof of Guselkumab effectiveness and safety in patients with moderate to severe psoriasis. Dermatol Ther. 2022;35(4):e15339. https://doi.org/10.1111/dth.15339.Michelucci A., Manzo Margiotta F., Panduri S., Tonini A., Romanelli M., Morganti R. et al. A real-life experience as a proof of Guselkumab effectiveness and safety in patients with moderate to severe psoriasis. Dermatol Ther. 2022;35(4):e15339. https://doi.org/10.1111/dth.15339.Gisondi P., Talamonti M., Chiricozzi A., Piaserico S., Amerio P., Balato A. et al. Treat-to-Target Approach for the Management of Patients with Moderate-toSevere Plaque Psoriasis: Consensus Recommendations. Dermatol Ther (Heidelb). 2021;11(1):235–252. https://doi.org/10.1007/s13555-020-00475-8.Gisondi P., Talamonti M., Chiricozzi A., Piaserico S., Amerio P., Balato A. et al. Treat-to-Target Approach for the Management of Patients with Moderate-toSevere Plaque Psoriasis: Consensus Recommendations. Dermatol Ther (Heidelb). 2021;11(1):235–252. https://doi.org/10.1007/s13555-020-00475-8.Di Cesare A., Di Meglio P., Nestle F.O. The IL-23/Th17 axis in the immunopathogenesis of psoriasis. J Invest Dermatol. 2009;129(6):1339–1350. https://doi.org/10.1038/jid.2009.59.Di Cesare A., Di Meglio P., Nestle F.O. The IL-23/Th17 axis in the immunopathogenesis of psoriasis. J Invest Dermatol. 2009;129(6):1339–1350. https://doi.org/10.1038/jid.2009.59.Oppmann B., Lesley R., Blom B., Timans J.C., Xu Y., Hunte B. et al. Novel p19 protein engages IL-12p40 to form a cytokine, IL-23, with biological activities similar as well as distinct from IL-12. Immunity. 2000;13(5):715–725. https://doi.org/10.1016/s1074-7613(00)00070-4.Oppmann B., Lesley R., Blom B., Timans J.C., Xu Y., Hunte B. et al. Novel p19 protein engages IL-12p40 to form a cytokine, IL-23, with biological activities similar as well as distinct from IL-12. Immunity. 2000;13(5):715–725. https://doi.org/10.1016/s1074-7613(00)00070-4.Langley R.G., Tsai T.F., Flavin S., Song M., Randazzo B., Wasfi Y. et al. Efficacy and safety of guselkumab in patients with psoriasis who have an inadequate response to ustekinumab: results of the randomized, doubleblind, phase III NAVIGATE trial. Br J Dermatol. 2018;178(1):114–123. https://doi.org/10.1111/bjd.15750.Langley R.G., Tsai T.F., Flavin S., Song M., Randazzo B., Wasfi Y. et al. Efficacy and safety of guselkumab in patients with psoriasis who have an inadequate response to ustekinumab: results of the randomized, doubleblind, phase III NAVIGATE trial. Br J Dermatol. 2018;178(1):114–123. https://doi.org/10.1111/bjd.15750.Sofen H., Smith S., Matheson R.T., Leonardi C.L., Calderon C., Brodmerkel C. et al. Guselkumab (an IL-23-specific mAb) demonstrates clinical and molecular response in patients with moderate-to-severe psoriasis. J Allergy Clin Immunol. 2014;133(4):1032–1040. https://doi.org/10.1016/j.jaci.2014.01.025.Sofen H., Smith S., Matheson R.T., Leonardi C.L., Calderon C., Brodmerkel C. et al. Guselkumab (an IL-23-specific mAb) demonstrates clinical and molecular response in patients with moderate-to-severe psoriasis. J Allergy Clin Immunol. 2014;133(4):1032–1040. https://doi.org/10.1016/j.jaci.2014.01.025.Markham A. Guselkumab: First Global Approval. Drugs. 2017;77(13):1487–1492. https://doi.org/10.1007/s40265-017-0800-7.Markham A. Guselkumab: First Global Approval. Drugs. 2017;77(13):1487–1492. https://doi.org/10.1007/s40265-017-0800-7.Nogueira M., Torres T. Guselkumab for the treatment of psoriasis – evidence to date. Drugs Context. 2019;8:212594. https://doi.org/10.7573/dic.212594.Nogueira M., Torres T. Guselkumab for the treatment of psoriasis – evidence to date. Drugs Context. 2019;8:212594. https://doi.org/10.7573/dic.212594.Gordon K.B., Duffin K.C., Bissonnette R., Prinz J.C., Wasfi Y., Li S. et al. A Phase 2 Trial of Guselkumab versus Adalimumab for Plaque Psoriasis. N Engl J Med. 2015;373(2):136–144. https://doi.org/10.1056/NEJMoa1501646.Gordon K.B., Duffin K.C., Bissonnette R., Prinz J.C., Wasfi Y., Li S. et al. A Phase 2 Trial of Guselkumab versus Adalimumab for Plaque Psoriasis. N Engl J Med. 2015;373(2):136–144. https://doi.org/10.1056/NEJMoa1501646.Blauvelt A., Papp K.A., Griffiths C.E., Randazzo B., Wasfi Y., Shen Y.K. et al. Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the continuous treatment of patients with moderate to severe psoriasis: Results from the phase III, double-blinded, placebo- and active comparator-controlled VOYAGE 1 trial. J Am Acad Dermatol. 2017;76(3):405–417. https://doi.org/10.1016/j.jaad.2016.11.041.Blauvelt A., Papp K.A., Griffiths C.E., Randazzo B., Wasfi Y., Shen Y.K. et al. Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the continuous treatment of patients with moderate to severe psoriasis: Results from the phase III, double-blinded, placebo- and active comparator-controlled VOYAGE 1 trial. J Am Acad Dermatol. 2017;76(3):405–417. https://doi.org/10.1016/j.jaad.2016.11.041.Reich K., Armstrong A.W., Foley P., Song M., Wasfi Y., Randazzo B. et al. Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the treatment of patients with moderate to severe psoriasis with randomized withdrawal and retreatment: Results from the phase III, double-blind, placebo- and active comparator-controlled VOYAGE 2 trial. J Am Acad Dermatol. 2017;76(3):418–431. https://doi.org/10.1016/j.jaad.2016.11.042.Reich K., Armstrong A.W., Foley P., Song M., Wasfi Y., Randazzo B. et al. Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the treatment of patients with moderate to severe psoriasis with randomized withdrawal and retreatment: Results from the phase III, double-blind, placebo- and active comparator-controlled VOYAGE 2 trial. J Am Acad Dermatol. 2017;76(3):418–431. https://doi.org/10.1016/j.jaad.2016.11.042.Reich K., Armstrong A.W., Langley R.G., Flavin S., Randazzo B., Li S. et al. Guselkumab versus secukinumab for the treatment of moderate-to-severe psoriasis (ECLIPSE): results from a phase 3, randomised controlled trial. Lancet. 2019;394(10201):831–839. https://doi.org/10.1016/S0140-6736(19)31773-8.Reich K., Armstrong A.W., Langley R.G., Flavin S., Randazzo B., Li S. et al. Guselkumab versus secukinumab for the treatment of moderate-to-severe psoriasis (ECLIPSE): results from a phase 3, randomised controlled trial. Lancet. 2019;394(10201):831–839. https://doi.org/10.1016/S0140-6736(19)31773-8.Benhadou F., Ghislain P.D., Guiot F., Willaert F., Del Marmol V., Lambert J. et al. Real-life effectiveness and short-term (16-week) tolerance of guselkumab for psoriasis: a Belgian retrospective multicentre study. J Eur Acad Dermatol Venereol. 2020;34(12):e837–e839. https://doi.org/10.1111/jdv.16715.Benhadou F., Ghislain P.D., Guiot F., Willaert F., Del Marmol V., Lambert J. et al. Real-life effectiveness and short-term (16-week) tolerance of guselkumab for psoriasis: a Belgian retrospective multicentre study. J Eur Acad Dermatol Venereol. 2020;34(12):e837–e839. https://doi.org/10.1111/jdv.16715.Zhuang J.Y., Li J.S., Zhong Y.Q., Zhang F.F., Li X.Z., Su H. et al. Evaluation of short-term (16-week) effectiveness and safety of guselkumab in patients with psoriasis: A prospective real-life study on the Chinese population. Dermatol Ther. 2021;34(5):e15054. https://doi.org/10.1111/dth.15054.Zhuang J.Y., Li J.S., Zhong Y.Q., Zhang F.F., Li X.Z., Su H. et al. Evaluation of short-term (16-week) effectiveness and safety of guselkumab in patients with psoriasis: A prospective real-life study on the Chinese population. Dermatol Ther. 2021;34(5):e15054. https://doi.org/10.1111/dth.15054.Budu-Aggrey A., Brumpton B., Tyrrell J., Watkins S., Modalsli E.H., Celis- Morales C. et al. Evidence of a causal relationship between body mass index and psoriasis: A mendelian randomization study. PLoS Med. 2019;16(1):e1002739. https://doi.org/10.1371/journal.pmed.1002739.Budu-Aggrey A., Brumpton B., Tyrrell J., Watkins S., Modalsli E.H., Celis- Morales C. et al. Evidence of a causal relationship between body mass index and psoriasis: A mendelian randomization study. PLoS Med. 2019;16(1):e1002739. https://doi.org/10.1371/journal.pmed.1002739.Paroutoglou K., Papadavid E., Christodoulatos G.S., Dalamaga M. Deciphering the Association Between Psoriasis and Obesity: Current Evidence and Treatment Considerations. Curr Obes Rep. 2020;9(3):165–178. https://doi.org/10.1007/s13679-020-00380-3.Paroutoglou K., Papadavid E., Christodoulatos G.S., Dalamaga M. Deciphering the Association Between Psoriasis and Obesity: Current Evidence and Treatment Considerations. Curr Obes Rep. 2020;9(3):165–178. https://doi.org/10.1007/s13679-020-00380-3.Foley P., Gordon K., Griffiths C.E.M., Wasfi Y., Randazzo B., Song M. et al. Efficacy of Guselkumab Compared With Adalimumab and Placebo for Psoriasis in Specific Body Regions: A Secondary Analysis of 2 Randomized Clinical Trials. JAMA Dermatol. 2018;154(6):676–683. https://doi.org/10.1001/jamadermatol.2018.0793.Foley P., Gordon K., Griffiths C.E.M., Wasfi Y., Randazzo B., Song M. et al. Efficacy of Guselkumab Compared With Adalimumab and Placebo for Psoriasis in Specific Body Regions: A Secondary Analysis of 2 Randomized Clinical Trials. JAMA Dermatol. 2018;154(6):676–683. https://doi.org/10.1001/jamadermatol.2018.0793.Schellekens H. Immunogenicity of therapeutic proteins: clinical implications and future prospects. Clin Ther. 2002;24(11):1720–1740. https://doi.org/10.1016/s0149-2918(02)80075-3.Schellekens H. Immunogenicity of therapeutic proteins: clinical implications and future prospects. Clin Ther. 2002;24(11):1720–1740. https://doi.org/10.1016/s0149-2918(02)80075-3.Mayer L., Young Y. Infusion reactions and their management. Gastroenterol Clin North Am. 2006;35(4):857–866. https://doi.org/10.1016/j.gtc.2006.09.006.Mayer L., Young Y. Infusion reactions and their management. Gastroenterol Clin North Am. 2006;35(4):857–866. https://doi.org/10.1016/j.gtc.2006.09.006.Hsu L., Armstrong A.W. Anti-drug antibodies in psoriasis: a critical evaluation of clinical significance and impact on treatment response. Expert Rev Clin Immunol. 2013;9(10):949–958. https://doi.org/10.1586/1744666X.2013.836060.Hsu L., Armstrong A.W. Anti-drug antibodies in psoriasis: a critical evaluation of clinical significance and impact on treatment response. Expert Rev Clin Immunol. 2013;9(10):949–958. https://doi.org/10.1586/1744666X.2013.836060.Thomas L.W., Lee E.B., Wu J.J. Systematic review of anti-drug antibodies of IL-17 inhibitors for psoriasis. J Dermatolog Treat. 2019;30(2):110–116. https://doi.org/10.1080/09546634.2018.1473552.Thomas L.W., Lee E.B., Wu J.J. Systematic review of anti-drug antibodies of IL-17 inhibitors for psoriasis. J Dermatolog Treat. 2019;30(2):110–116. https://doi.org/10.1080/09546634.2018.1473552.Norden A., Moon J.Y., Javadi S.S., Munawar L., Maul J.T., Wu J.J. Anti-drug antibodies of IL-23 inhibitors for psoriasis: a systematic review. J Eur Acad Dermatol Venereol. 2022;36(8):1171–1177. https://doi.org/10.1111/jdv.18042.Norden A., Moon J.Y., Javadi S.S., Munawar L., Maul J.T., Wu J.J. Anti-drug antibodies of IL-23 inhibitors for psoriasis: a systematic review. J Eur Acad Dermatol Venereol. 2022;36(8):1171–1177. https://doi.org/10.1111/jdv.18042.Gordon K.B., Armstrong A.W., Foley P., Song M., Shen Y.K., Li S. et al. Guselkumab Efficacy after Withdrawal Is Associated with Suppression of Serum IL-23-Regulated IL-17 and IL-22 in Psoriasis: VOYAGE 2 Study. J Invest Dermatol. 2019;139(12):2437–2446.e1. https://doi.org/10.1016/j.jid.2019.05.016.Gordon K.B., Armstrong A.W., Foley P., Song M., Shen Y.K., Li S. et al. Guselkumab Efficacy after Withdrawal Is Associated with Suppression of Serum IL-23-Regulated IL-17 and IL-22 in Psoriasis: VOYAGE 2 Study. J Invest Dermatol. 2019;139(12):2437–2446.e1. https://doi.org/10.1016/j.jid.2019.05.016.Ferris L.K., Ott E., Jiang J., Hong H.C., Li S., Han C., Baran W. Efficacy and safety of guselkumab, administered with a novel patient-controlled injector (One-Press), for moderate-to-severe psoriasis: results from the phase 3 ORION study. J Dermatolog Treat. 2020;31(2):152–159. https://doi.org/10.1080/09546634.2019.1587145.Ferris L.K., Ott E., Jiang J., Hong H.C., Li S., Han C., Baran W. Efficacy and safety of guselkumab, administered with a novel patient-controlled injector (One-Press), for moderate-to-severe psoriasis: results from the phase 3 ORION study. J Dermatolog Treat. 2020;31(2):152–159. https://doi.org/10.1080/09546634.2019.1587145.Ohtsuki M., Kubo H., Morishima H., Goto R., Zheng R., Nakagawa H. Guselkumab, an anti-interleukin-23 monoclonal antibody, for the treatment of moderate to severe plaque-type psoriasis in Japanese patients: Efficacy and safety results from a phase 3, randomized, double-blind, placebo-controlled study. J Dermatol. 2018;45(9):1053–1062. https://doi.org/10.1111/1346-8138.14504.Ohtsuki M., Kubo H., Morishima H., Goto R., Zheng R., Nakagawa H. Guselkumab, an anti-interleukin-23 monoclonal antibody, for the treatment of moderate to severe plaque-type psoriasis in Japanese patients: Efficacy and safety results from a phase 3, randomized, double-blind, placebo-controlled study. J Dermatol. 2018;45(9):1053–1062. https://doi.org/10.1111/1346-8138.14504.Zhu Y., Marini J.C., Song M., Randazzo B., Shen Y.K., Li S., Zhou H. Immunogenicity of Guselkumab Is Not Clinically Relevant in Patients with Moderateto-Severe Plaque Psoriasis. J Invest Dermatol. 2019;139(8):1830–1834.e6. https://doi.org/10.1016/j.jid.2019.02.018.Zhu Y., Marini J.C., Song M., Randazzo B., Shen Y.K., Li S., Zhou H. Immunogenicity of Guselkumab Is Not Clinically Relevant in Patients with Moderateto-Severe Plaque Psoriasis. J Invest Dermatol. 2019;139(8):1830–1834.e6. https://doi.org/10.1016/j.jid.2019.02.018.Ruggiero A., Fabbrocini G., Cinelli E., Megna M. Guselkumab and Risankizumab for psoriasis: a 44-week indirect real-life comparison. J Am Acad Dermatol. 2021;85(4):1028–1030. https://doi.org/10.1016/j.jaad.2021.01.025.Ruggiero A., Fabbrocini G., Cinelli E., Megna M. Guselkumab and Risankizumab for psoriasis: a 44-week indirect real-life comparison. J Am Acad Dermatol. 2021;85(4):1028–1030. https://doi.org/10.1016/j.jaad.2021.01.025.Ruggiero A., Fabbrocini G., Cinelli E., Megna M. Efficacy and safety of guselkumab in psoriasis patients who failed ustekinumab and/or anti-interleukin-17 treatment: A real-life 52-week retrospective study. Dermatol Ther. 2021;34(1):e14673. https://doi.org/10.1111/dth.14673.Ruggiero A., Fabbrocini G., Cinelli E., Megna M. Efficacy and safety of guselkumab in psoriasis patients who failed ustekinumab and/or anti-interleukin-17 treatment: A real-life 52-week retrospective study. Dermatol Ther. 2021;34(1):e14673. https://doi.org/10.1111/dth.14673.Ruiz-Villaverde R., Rodriguez-Fernandez-Freire L., Armario-Hita J.C., Pérez-Gil A., Chinchay F.V., Galán-Gutiérrez M. Guselkumab as a switching strategy after anti-TNFα, anti-IL17, or anti-IL12/23 therapies in moderate-to-severe psoriasis. Dermatol Ther. 2022;35(10):e15760. https://doi.org/10.1111/dth.15760.Ruiz-Villaverde R., Rodriguez-Fernandez-Freire L., Armario-Hita J.C., Pérez-Gil A., Chinchay F.V., Galán-Gutiérrez M. Guselkumab as a switching strategy after anti-TNFα, anti-IL17, or anti-IL12/23 therapies in moderate-to-severe psoriasis. Dermatol Ther. 2022;35(10):e15760. https://doi.org/10.1111/dth.15760.

The authors declare that there are no conflicts of interest present.