Psoriasis, comorbid obesity, and the efficacy of the IL‑23 inhibitor guselkumab based on clinical cases

Epidemiological studies demonstrate a close relationship between psoriasis and concomitant metabolic diseases, including obesity, hypertension, diabetes mellitus, dyslipidemia, and non-alcoholic fatty liver disease. The presence of concomitant metabolic diseases has a significant impact on the choice and effectiveness of pharmacological treatment. Due to the increased risk of adverse events in patients with psoriasis and comorbidities, some drugs should be prescribed with special caution, while some drugs show low efficacy. The IL‑23 inhibitor guselkumab may be a better therapeutic alternative for patients with psoriasis and metabolic disorders, including obesity, compared with disease-modifying antirheumatic drugs (such as methotrexate, acitretin) and other classes of biological drugs. In patients with moderate to severe psoriasis, the IL‑23 inhibitor guselkumab shows a high treatment outcome with PASI 90 and PASI 100 achieved, regardless of BMI. The presented publication describes observations of patients with moderate to severe psoriasis, comorbidities and high efficiency of genetically engineered biological therapy with an IL‑23 inhibitor (guselkumab).

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