{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:57:52Z","timestamp":1785473872690,"version":"3.56.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Interleukin (IL)-23 inhibitors are highly effective therapies for psoriasis, but some patients may need to discontinue the treatment. Intraclass switching is a potential strategy, although data on its effectiveness remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the patterns and effectiveness of intraclass switching among IL-23 inhibitors in a real-world setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, multicentre study included adult patients with plaque psoriasis who switched between IL-23 inhibitors. Clinical and demographic data were analysed, and univariable and multivariable analyses identified predictors of treatment response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We analysed 116 patients (120 switches). Switching occurred from guselkumab (45.0%), tildrakizumab (44.2%) and risankizumab (10.8%), mainly due to secondary ineffectiveness (82.5%). Risankizumab was the most common post-switch agent (70.0%), followed by guselkumab (23.3%) and tildrakizumab (6.7%). Psoriasis Area and Severity Index 90% improvement (PASI 90) rates were 28.5% at week 16, 49.5% at week 36 and 60.7% at week 52. Fifteen patients (12.5%) withdrew from treatment, mainly due to lack of efficacy (10 patients, 67%) or adverse events (4 patients, 27%). Univariate analysis showed lower PASI 90 achievement in patients with psoriatic arthritis at weeks 16 after the switch (P = 0.02) and 36 (P = 0.02) and in those with body mass index (BMI) \u2265 25\u2005kg m\u20132 at week 52 (P = 0.01). Patients switching from risankizumab had lower PASI 90 rates at weeks 16 (P = 0.04) and 36 (P = 0.03), while those switching to risankizumab had higher PASI 90 rates at week 16 (P = 0.02). Multivariate analysis confirmed BMI \u2265 25\u2005kg m\u20132 was associated with reduced PASI 90 at weeks 36 (P = 0.04) and 52 (P = 0.04).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Intraclass switching among IL-23 inhibitors is an effective strategy, with risankizumab emerging as the most favourable option.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ced\/llaf476","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T13:18:10Z","timestamp":1761743890000},"page":"451-456","source":"Crossref","is-referenced-by-count":3,"title":["Intraclass switching of interleukin-23 inhibitors in psoriasis: effectiveness, patterns and predictors of response \u2013 a retrospective multicentre study in Italy"],"prefix":"10.1093","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8837-9232","authenticated-orcid":false,"given":"Giacomo","family":"Caldarola","sequence":"first","affiliation":[{"name":"UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"De Luca","sequence":"additional","affiliation":[{"name":"UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Balato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Burlando","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Carugno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Giunta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Lembo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Manfredini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Megna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaia","family":"Moretta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Letizia","family":"Musumeci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Ribero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Trovato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"2026022406171658800_llaf476-B1","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1080\/14712598.2022.2132143","article-title":"Anti-IL 23 biologics for the treatment of plaque psoriasis","volume":"22","author":"Vu","year":"2022","journal-title":"Expert Opin Biol Ther"},{"key":"2026022406171658800_llaf476-B2","doi-asserted-by":"crossref","first-page":"409","DOI":"10.2147\/ITT.S240891","article-title":"The role of IL-17 cytokines in psoriasis","volume":"10","author":"Mosca","year":"2021","journal-title":"Immunotargets Ther"},{"key":"2026022406171658800_llaf476-B3","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1093\/ced\/llac098","article-title":"Drug survival and efficacy of anti-interleukin 23 biologics in psoriasis: a comparative study on different agents","volume":"48","author":"Roccuzzo","year":"2023","journal-title":"Clin Exp Dermatol"},{"key":"2026022406171658800_llaf476-B4","doi-asserted-by":"crossref","first-page":"2319304","DOI":"10.1080\/09546634.2024.2319304","article-title":"Efficacy and safety of tildrakizumab in elderly patients: real-world multicenter study (ESTER - study)","volume":"35","author":"Orsini","year":"2024","journal-title":"J Dermatolog Treat"},{"key":"2026022406171658800_llaf476-B5","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.2147\/CCID.S364640","article-title":"Guselkumab, risankizumab, and tildrakizumab in the management of psoriasis: a review of the real-world evidence","volume":"15","author":"Ruggiero","year":"2022","journal-title":"Clin Cosmet Investig Dermatol"},{"key":"2026022406171658800_llaf476-B6","first-page":"1","article-title":"Italian adaptation of EuroGuiDerm guideline on the systemic treatment of chronic plaque psoriasis","volume":"157","author":"Gisondi","year":"2022","journal-title":"Ital J Dermatol Venerol"},{"key":"2026022406171658800_llaf476-B7","doi-asserted-by":"crossref","first-page":"e144","DOI":"10.1111\/jdv.20192","article-title":"Comparative analysis of switching strategies for IL-23 and IL-17A inhibitors for the treatment of psoriasis: interclass switching outperforms intraclass switching","volume":"39","author":"Nam","year":"2025","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2026022406171658800_llaf476-B8","doi-asserted-by":"crossref","first-page":"e952","DOI":"10.1111\/jdv.18381","article-title":"Real-life intraclass switch among IL-17 inhibitors in psoriasis: results from a single-centre, 24-week, retrospective study","volume":"36","author":"Sotiriou","year":"2022","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2026022406171658800_llaf476-B9","doi-asserted-by":"crossref","first-page":"5557255","DOI":"10.1155\/2023\/5557255","article-title":"Intraclass switching among IL17 inhibitors in psoriasis: a real-life, long-term single-center experience","volume":"2023","author":"Cavallo","year":"2023","journal-title":"Dermatol Ther"},{"key":"2026022406171658800_llaf476-B10","doi-asserted-by":"crossref","first-page":"769","DOI":"10.2340\/00015555-3200","article-title":"IL-17A inhibitor switching \u2013 efficacy of ixekizumab following secukinumab failure. 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