Guselkumab and risankizumab represent the newest class of biologics for plaque psoriasis. Their mechanism targets:

• A IL-12 and IL-23 (shared p40 subunit)
• B TNFα receptor fusion protein
• C PDE4 inhibition
• D IL-23 specifically (p19 subunit) ✓

Explanation

Guselkumab, risankizumab and tildrakizumab are selective anti-IL-23 biologics that specifically target the p19 subunit of IL-23. This differentiates them from ustekinumab, which targets the p40 subunit shared by both IL-12 and IL-23. Selective IL-23 blockade prevents the generation and maintenance of pathogenic Th17 cells without affecting IL-12-driven Th1 immunity, potentially providing better safety profile. These agents show superior skin clearance rates (PASI 90/100 responses) over anti-TNF and anti-IL-17 biologics in head-to-head trials.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.