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The International Psoriasis Council (IPC) and the National Psoriasis Foundation (NPF) Medical Board have published a new joint position statement in the Journal of the American Academy of Dermatology (JAAD) titled Joint Position Statement from the National Psoriasis Foundation Medical Board and the International Psoriasis Council on Routine Testing for Latent Tuberculosis Infection Prior To and During Treatment of Psoriasis Patients with IL-17 or IL-23 Inhibitors.
This publication addresses a long-standing clinical question in psoriasis care: whether routine testing for latent tuberculosis (TB) infection is necessary for patients treated with IL-17 or IL-23 inhibitors.
Drawing on clinical trial data, real-world evidence, and safety reports, experts from IPC and the NPF Medical Board reviewed the risk of progression from latent TB infection to active disease in patients with psoriasis who received IL-17 or IL-23 inhibitors. Based on this review, they formulated and endorsed a joint position statement to guide clinical practice.
The paper highlights the following key points:
- Routine Testing: Routine testing for latent TB infection is not required prior to or during treatment of psoriasis patients with IL-17 or IL-23 inhibitors.
- Exceptions: Continued TB testing may still be considered for patients receiving concomitant immunosuppressive therapy or those living in TB endemic areas.
- Evidence Base: Available clinical trial and real-world data indicate that progression from latent TB infection to active TB during treatment with IL-17 or IL-23 inhibitors is rare, especially when contrasted with historical experience using TNF inhibitors.
- Regulatory and Practical Implications: Updating clinical and regulatory expectations regarding TB testing for these drug classes could reduce unnecessary testing, lower costs, mitigate the impact of false-positive results, and help prevent delays in initiating effective psoriasis treatment.
- Consensus Process: The position statement reflects broad agreement among psoriasis experts, with 87.5 percent of voting members from IPC Board Members and Councilors and the NPF Medical Board supporting the final recommendation.
This joint statement is an important step toward aligning TB testing practices with current evidence on IL-17 and IL-23 inhibitor safety, helping clinicians make informed decisions while minimizing unnecessary testing and treatment delays for people living with psoriasis.
