Efficacy of biologics in the treatment of moderate‐to‐severe plaque psoriasis: a systematic review and meta‐analysis of randomized controlled trials with different time points

Puig, Lluís; López, Antonio Pascual; Vilarrasa, Eva; García, I.

doi:10.1111/jdv.12238

Cited by 70 publications

(52 citation statements)

References 37 publications

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“…Consistent with previous reports,10 IL‐17 inhibitors appeared to be the most efficacious injectable/infusible psoriasis treatments, followed by other classes of drugs. Infliximab (5 mg/kg) and ixekizumab (80 mg) had the highest responses among TNF‐α inhibitors and IL‐17 inhibitors, respectively.…”

Section: Discussionsupporting

confidence: 91%

Quantitative Evaluations of Time‐Course and Treatment Effects of Systemic Agents for Psoriasis: A Model‐Based Meta‐Analysis

Checchio

Ahadieh

Gupta

et al. 2017

Clin Pharma and Therapeutics

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Aggregate data model‐based meta‐analysis is a regression approach to compare the dose–response and/or time‐course across different treatments using summary level data from the literature. Literature search and systematic review following the Cochrane approach yielded 912 sources for investigational and approved treatments for psoriasis. In addition, data for tofacitinib were obtained from an internal database. Tofacitinib is an oral Janus kinase inhibitor. Two mathematical models were developed for Psoriasis Area and Severity Index (PASI) response in moderate to severe psoriasis patients to quantify the time to maximum effect for PASI75 and to evaluate the dose–response relationship for PASI responders (PASI50, PASI75, PASI90, PASI100) at Week 12. Body weight exhibited an inverse effect on the placebo component of both models, suggesting that body weight affects the overall PASI response regardless of drug. This analysis provides a quantitative framework for efficacy comparisons across psoriasis treatments.

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Section: Discussionsupporting

confidence: 91%

Quantitative Evaluations of Time‐Course and Treatment Effects of Systemic Agents for Psoriasis: A Model‐Based Meta‐Analysis

Checchio

Ahadieh

Gupta

et al. 2017

Clin Pharma and Therapeutics

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“…One direct openlabel comparative study between ustekinumab and etanercept showed superiority of ustekinumab regarding PASI-75 [32]. Other metaanalysis concluded that ustekinunab and infliximab were the most efficacious agents, followed by adalimumab and etanercept [60][61][62]. Because only one (open label) direct comparative study was performed, these results must be interpreted with caution.…”

Section: Discussionmentioning

confidence: 92%

“…Limited data are available concerning long-term efficacy of the drugs [61,62]. The efficacy of adalimumab and infliximab seems to decrease over time [19], while there are no data indicating a decreased efficacy over time for etanercept.…”

Section: Discussionmentioning

confidence: 96%

Biologicals in the Treatment of Plaque Psoriasis: Drug Selection by Means of the SOJA Method

Janknegt¹

2016

J Pharma Care Health Sys

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The treatment of plaque psoriasis is changing because of the introduction of new treatment options. The goal of this article is to allow a transparent and rational choice of medicines by means of the System of Objectified Judgement Analysis. The following selection criteria (relative weight) were applied: approved indications (40), drug interactions (60), clinical efficacy (400), safety (300), dosage frequency (100) and documentation (100). Acquisition cost was not taken into consideration to allow a preselection on quality aspects only. Adalimumab, etanercept, infliximab and ustekinumab were compared on these criteria. Infliximab and ustekinumab showed the highest scores and are the most suitable medicines for the treatment of severe plaque psoriasis. Of course, cost will play a key role in the final selection in individual hospitals. Weight Approved indications 40 Drug Interactions 60Clinical efficacy 400Safety 300Dosage frequency 100 Documentation 100Total 1000 Selection Criteria Approved IndicationsThe number of licensed indications is a good measure of the applicability and documentation of the drugs. Although this analysis is limited to the treatment of plaque psoriasis, the fact that a drug is approved for (almost) all indications listed below is, from a formulary point of view, advantageous to another drug, which is approved for only one or two applications.The percentage of the maximum score for approved indications was obtained as follows (Table 2): IndicationMaximum Score (%)Plaque psoriasis 50% Psoriatric arthritis 20%Rheumatoid arthritis 10% Spondylitis ankylopoetica 10%Inflammatory bowel disease 10% Drug interactionsInteractions play a role only in patients who use other drugs which may interact with biologicals. However, it is a relevant criterion from a formulary point of view.The score for each drug was dependent on the frequency and severity of observed drug interactions. Clinical efficacyClinical efficacy is always a very important selection criterion for any group of drugs. The score for each drug was derived from the results of double-blind comparative studies. SafetyThe extent and the severity of adverse effects is another important selection criterion for drugs. A distinction was made between "minor" side effects, such as gastrointestinal disturbances or skin reactions, occurring in clinical trials and severe or even life-threatening adverse reactions observed with large scale use of the drugs. The evaluation of the "minor" adverse effects was based on results of double blind comparative clinical studies.

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“…ADA and INF are more effective than the ETN in the treatment of plaque psoriasis [4]. The most common adverse effects of ADA and ETN (subcutaneous use) are reactions in application sites while the most common adverse effects related to INF (intravenous use) are infusion reactions [5].…”

Section: Introductionmentioning

confidence: 99%

“…The inhibitors of interleukins (ustekinumab -UST and secukinumab -SEC) are more effective in the treatment of plaque psoriasis than the anti-TNF agents [4,6] as they act directly on the Interleukin (IL) -23/17 axis (the protagonist of the immunopathogenesis of psoriasis) [7]. By the way, the main mechanism of action of the anti-TNF agents in plaque psoriasis appears to be the inhibition of sTNF involved in the activation of dermal dendritic cells (which are potent sources of IL-23).…”

Section: Introductionmentioning

confidence: 99%

Mechanism of action of the biologics used in the treatment of plaque psoriasis

Sanchez¹

2017

CRDOA

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The biologics modified the treatment of plaque psoriasis in recent years. It is important that dermatologists know the mechanism of action of these drugs so they can better understand their indications and side effects. In this article we will discuss the mechanism of action of five biologics used in the treatment of plaque psoriasis: three anti-tumour necrosis factor agents (infliximab, adalimumab and etanercept) and two interleukin inhibitors (ustekinumab and secukinumab). 2

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Efficacy of biologics in the treatment of moderate‐to‐severe plaque psoriasis: a systematic review and meta‐analysis of randomized controlled trials with different time points

Cited by 70 publications

References 37 publications

Quantitative Evaluations of Time‐Course and Treatment Effects of Systemic Agents for Psoriasis: A Model‐Based Meta‐Analysis

Quantitative Evaluations of Time‐Course and Treatment Effects of Systemic Agents for Psoriasis: A Model‐Based Meta‐Analysis

Biologicals in the Treatment of Plaque Psoriasis: Drug Selection by Means of the SOJA Method

Mechanism of action of the biologics used in the treatment of plaque psoriasis

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