Comparative Effects of IL-17 and IL-23 Inhibitors on Lipid Profiles and Lipid-Derived Atherogenic Indices in Patients with Psoriasis

Background: Psoriasis is associated with increased cardiovascular risk and altered lipid metabolism. The comparative effects of IL-17 and IL-23 inhibitors on lipid-derived atherogenic indices remain unclear. Objective: To compare the effects of IL-17 and IL-23 inhibitors on lipid parameters and lipid-derived atherogenic indices in patients with psoriasis. Methods: In this retrospective cohort study, 152 patients were assessed for eligibility, and 108 were included: 51 receiving IL-23 inhibitors and 57 receiving IL-17 inhibitors. Lipid parameters, lipid-derived indices, and PASI were evaluated at baseline and after 12 months. Results: Both groups achieved marked PASI improvement. IL-23 inhibitors were associated with significant reductions in total cholesterol, non-HDL-C, triglycerides, VLDL-C, remnant cholesterol, AIP, TG/HDL-C ratio, CRI-I, CRI-II, and AC, whereas only the TG/HDL-C ratio decreased significantly in the IL-17 group. Between-group comparisons showed greater reductions with IL-23 inhibitors in these parameters and indices (all p < 0.05), while changes in PASI, LDL-C, and HDL-C were comparable. Conclusion: IL-23 inhibitors were associated with greater improvements in several lipid parameters and lipid-derived atherogenic indices than IL-17 inhibitors despite comparable clinical efficacy. These findings should not be interpreted as evidence of differential cardiovascular protection.