In Part 3 of the Across the Rheum podcast series, Dr. Sergio Schwartzman concludes the three-part discussion on the IL-23 paradigm in psoriatic arthritis (PsA) with a deep dive into clinical utility, treatment positioning, and real-world decision-making. Building on prior episodes that covered immunologic mechanisms and comparative trial data, this final installment focuses on how IL-23 inhibitors are being integrated into modern PsA treatment algorithms.

Joined by Jessica Farrell, PharmD, and Dr. Monica Schwarzman, the discussion explores where IL-23 inhibitors fit relative to methotrexate, TNF inhibitors, and IL-17 inhibitors, with thoughtful analysis of treatment persistence, safety profiles, radiographic progression, and comorbidity considerations, including inflammatory bowel disease. The episode also addresses evolving practice patterns, payer access considerations, and why many clinicians are moving toward earlier use of targeted biologic therapy in appropriate patients.

Additional insights include the role of radiographic progression prevention, interpretation of modified Sharp scores, and future directions in PsA care—such as axial psoriatic arthritis, combination biologic therapy, difficult-to-treat disease, and emerging oral and long-acting agents.

Subscribe to Across the Rheum for ongoing expert-led discussions on evolving therapies in rheumatology.

In Part 2 of the Across the Rheum podcast series, host Dr. Sergio Schwartzman continues the three-part discussion on the IL-23 paradigm in psoriatic arthritis (PsA). This episode takes a focused, clinical look at the currently available IL-23 inhibitors, reviewing their mechanisms of action, structural differences, dosing strategies, and FDA-approved indications across psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis.

Joined again by Jessica Farrell, PharmD, and Dr. Monica Schwarzman, the conversation examines p19 vs p40 IL-23 inhibition, compares key clinical trial efficacy data in both psoriasis and psoriatic arthritis, and discusses how these data may inform real-world treatment decisions. The episode also explores class switching, limitations of cross-trial comparisons, and the evolving role of head-to-head studies in rheumatology.

This episode is designed for rheumatology clinicians and APPs seeking practical insight into how IL-23 inhibitors are differentiated and positioned in modern PsA management.

Stay tuned for Part 3, where the series concludes with clinical positioning and real-world application of IL-23–directed therapies.

Welcome to the premiere of Across the Rheum, the official podcast of Rheum Connect, where cutting-edge science meets real-world clinical insight in rheumatology. Hosted by renowned rheumatologist Dr. Sergio Schwartzman, this new educational podcast launches with a three-part series exploring The Interleukin-23 (IL-23) Paradigm in Psoriatic Arthritis.

In Episode 1, the series sets the foundation with an in-depth discussion of IL-23 immunology and its role in the pathophysiology of psoriatic disease. Joined by expert guests Jessica Farrell, PharmD, and Dr. Monica Schwarzman, listeners gain a structured understanding of the IL-23/Th17 pathway, cytokine signaling, and how these mechanisms translate into targeted therapeutic strategies for psoriatic arthritis and related immune-mediated diseases.

Designed for rheumatologists, advanced practice providers, pharmacists, and clinicians involved in inflammatory arthritis care, this episode examines why IL-23 has emerged as a critical therapeutic target, the scientific rationale behind selective inhibition, and how evolving immunologic insights are shaping modern treatment decisions. The discussion also highlights key distinctions between IL-23– and IL-17–driven disease, implications for axial involvement, and the future of precision therapy in psoriatic arthritis.

This episode is cross-hosted on Across The Rheum and the RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers, with sincere thanks to RhAPP for their continued partnership. Educational support for this activity is provided by Johnson & Johnson.

Subscribe to Across the Rheum to continue the series in Episode 2, where the conversation shifts to a detailed review of currently available IL-23 inhibitors, clinical trial data, and practical positioning in today’s rheumatology treatment landscape.