A comprehensive meta-analysis of 24 randomized clinical trials involving 12,661 psoriasis patients provides critical insight into the effectiveness and safety of interclass biologic switching. Data indicate that transitions, particularly from anti–TNF-α or anti–IL-12/23p40 agents to IL-23p19 inhibitors, yield faster PASI 90 responses and more stable long-term control compared to intra-class strategies. However, the enhanced efficacy carries a measurable infection signal, most pronounced when switching from TNF-α antagonists to IL-23p19, IL-17A, or IL-12/23p40 agents.
Importantly, no major differences emerged in overall serious adverse events, underscoring that the safety profile remains acceptable under vigilant monitoring. These findings highlight a dual imperative for clinicians: leveraging the mechanistic diversity of biologics to overcome primary or secondary non-response, while…
