Background Elderly patients (≥65 years) represent an increasing rate of psoriatic patients, 15% have moderate-to-severe disease. Biologics are being frequently used even if safety and efficacy data are limited. Objective Evaluate and compare guselkumab, risankizumab, and tildrakizumab safety and efficacy in real-word-practice in elderly patients. Methods A 40/44 weeks single-center retrospective study enrolled patients aged≥65 years suffering from moderate-to-severe plaque-psoriasis, treated with guselkumab, risankizumab, or tildrakizumab. Results Thirty-four patients were enrolled (n=20 guselkumab; n=8 risankizumab; n=6 tildrakizumab). At week 4, 29.4% reached PASI90 and 8.8% PASI100; at week 28, PASI90 and PASI100 were observed in 58.8% and 29.4%, respectively. At week 40-44, data are available only for guselkumab and risankizumab groups in which 71.4% reached PASI90 and 53.5% PASI100. Four patients (11.7%) discontinued treatment. No significant differences were found among groups. Limitations Retrospective nature of the study, small sample size, non-equal follow-up duration among the groups, lower number of tildrakizumab patients, and higher components of guselkumab (different commercialization date). Conclusion Anti-IL-23s are promising, safe, and effective treatment options in elderlies without significant difference among them. However, more data are needed to confirm our results and to understand their role in the management of these more fragile patients.

Interleukin (IL)-23 inhibitors, guselkumab, risankizumab, and tildrakizumab, represent the latest class of biologics approved for the treatment of moderate-to-severe psoriasis. Since their approval numerous real-life studies were published on anti-IL-23 use in routine clinical practice. Indeed, real-life data are important to improve the dermatological decision-making process, including patients who are typically excluded from clinical trials, such as subjects suffering from several comorbidities, subjects on polypharmacy, as well as multifailure patients. Herein, we performed a comprehensive literature review about real-life data available on guselkumab, risankizumab, and tildrakizumab. Real-life data of anti-IL-23 seem to confirm the promising results of IL-23 shown by clinical trials, highlighting the efficacy and safety profiles of this new class of biologics also in clinical practice.

Guselkumab, tildrakizumab and risankizumab, acting on interleukin(IL)23 axis, have been recently approved for psoriasis management. However, real-life data regarding their comparison are scant.The ...

Magnetic resonance imaging (MRI) offers excellent spatial and contrast resolution for evaluating a wide variety of pathologies, without exposing patients to ionizing radiations. Additionally, MRI offers reproducible diagnostic imaging results that are not operator-dependent, a major advantage over ultrasound. MRI is commonly used in pregnant women to evaluate, most frequently, acute abdominal and pelvic pain or placental abnormalities, as well as neurological or fetal abnormalities, infections, or neoplasms. However, to date, our knowledge about MRI safety during pregnancy, especially about the administration of gadolinium-based contrast agents, which are able to cross the placental barrier, is still limited, raising concerns about possible negative effects on both the mother and the health of the fetus. Contrast agents that are unable to cross the placenta in a way that is safe for the fetus are desirable. In recent years, some preclinical studies, carried out in rodent models, have evaluated the role of long circulating liposomal nanoparticle-based blood-pool gadolinium contrast agents that do not penetrate the placental barrier due to their size and therefore do not expose the fetus to the contrast agent during pregnancy, preserving it from any hypothetical risks. Hence, we performed a literature review focusing on contrast and non-contrast MRI use during pregnancy.

Personalized medicine is the new frontier in psoriasis as it may allow a patient-tailored management with treatment optimization and reduction of side effects as well as health costs [1]. Thanks to...