Safety of biologics in psoriasis

Kamata, Masahiro; Tada, Yayoi

doi:10.1111/1346-8138.14096

Cited by 106 publications

(97 citation statements)

References 118 publications

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“…However, accumulating evidence revealed drug-specific concerns. We have already discussed the safety concerns of biologics in the previous literature [53]. Therefore, we refer to this issue in brief.…”

Section: Safety Concerns Of Biologicsmentioning

confidence: 99%

Efficacy and Safety of Biologics for Psoriasis and Psoriatic Arthritis and Their Impact on Comorbidities: A Literature Review

Kamata

Tada

2020

IJMS

Self Cite

150

116

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Psoriasis is a chronic inflammatory skin disease characterized by scaly indurated erythema. It impairs patients’ quality of life enormously. It has been recognized not only as a skin disease but as a systemic disease, since it also causes arthritis (psoriatic arthritis) and mental disorders. Furthermore, an association with cardiovascular events is indicated. With the advent of biologics, treatment of psoriasis dramatically changed due to its high efficacy and tolerable safety. A variety of biologic agents are available for the treatment of psoriasis nowadays. However, characteristics such as rapidity of onset, long-term efficacy, safety profile, and effects on comorbidities are different. Better understanding of those characteristic leads to the right choice for individual patients, resulting in higher persistence, longer drug survival, higher patient satisfaction, and minimizing the disease impact of psoriasis. In this paper, we focus on the efficacy and safety profile of biologics in psoriasis patients, including plaque psoriasis and psoriatic arthritis. In addition, we discuss the impact of biologics on comorbidities caused by psoriasis.

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Section: Safety Concerns Of Biologicsmentioning

confidence: 99%

Efficacy and Safety of Biologics for Psoriasis and Psoriatic Arthritis and Their Impact on Comorbidities: A Literature Review

Kamata

Tada

2020

IJMS

Self Cite

150

116

View full text Add to dashboard Cite

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“…Most patients showed complete resolution after antifungal treatment. Rates of serious infections for all IL-17 agents are comparable to placebo [13,14].…”

Section: Il-17 Agents (Secukinumab Ixekizumab Brodalumab)mentioning

confidence: 91%

“…The proportion of patients with any AEs was slightly lower in treatment with IL-23 inhibitors compared to treatment with IL-17 inhibitors [15]. In general, malignancy rates are slightly higher in psoriatic patients than the common adult population [13]. Limited data exist regarding any carcinogenic potential of the IL-17 and IL-23 agents, but to date, these treatments do not appear to increase malignancy risk.…”

Section: Il-23 Agents -Il-23p19 Inhibitors (Guselkumab Tildrakizumabmentioning

confidence: 95%

“…As such, it is important that TB screening occur prior to the initiation of treatment and annually with any TNF-α inhibitor in order to prevent development of active TB and reactivation of latent TB [9]. There have been reports of several cases of interstitial pneumonia in patients receiving TNF-α inhibitors, however this association is controversial and has not been determined to be an absolute risk of these agents [13].…”

Section: Tnf-alpha Inhibitors (Adalimumab Etanercept Infliximab Cementioning

confidence: 99%

“…Although a direct causal relationship has not been established between IL-17 agents and IBD, appropriate screening and caution is recommended when considering IL-17 agents in patients with a history of IBD. Alternative treatment options should be considered in patients with a definitive IBD diagnosis [13,14].…”

Section: Il-17 Agents (Secukinumab Ixekizumab Brodalumab)mentioning

confidence: 99%

See 2 more Smart Citations

How can we manage the safety concerns associated with the increase in biologics for psoriasis?

Silfvast‐Kaiser

Menter

2020

Expert Opinion on Drug Safety

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Melanoma Risk in Patients Treated With Biologic Therapy for Common Inflammatory Diseases

et al. 2020

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IMPORTANCE Biologic therapies are widely prescribed immunomodulatory agents. There are concerns that compared with treatment with conventional systemic therapy, long-term biologic treatment for common immune-mediated inflammatory diseases, namely inflammatory bowel disease (IBD), rheumatoid arthritis (RA), and psoriasis, may be associated with increased risk of melanoma.OBJECTIVE To examine whether biologic treatment of IBD, RA, or psoriasis is associated with an increased risk of melanoma compared with conventional systemic therapy.DATA SOURCES Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for articles published from January 1, 1995, to February 7, 2019, for eligible studies.STUDY SELECTION Randomized clinical trials, cohort studies, and nested case-control studies quantifying the risk of melanoma in biologic-treated patients with IBD, RA, and psoriasis compared with patients treated with conventional systemic therapy were included.DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted key study characteristics and outcomes. Study-specific risk estimates were pooled, and random-and fixed-effects model meta-analyses were conducted. Heterogeneity was assessed using the I 2 statistic. The Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines were followed. MAIN OUTCOMES AND MEASURESThe pooled relative risk (pRR) of melanoma in biologic-treated patients with IBD, RA, and psoriasis compared with biologic-naive patients treated with conventional systemic therapy. RESULTSSeven cohort studies comprising 34 029 biologic-treated patients and 135 370 biologic-naive patients treated with conventional systemic therapy were eligible for inclusion. Biologic treatment was positively associated with melanoma in patients with IBD (pRR, 1.20; 95% CI, 0.60-2.40), RA (pRR, 1.20; 95% CI, 0.83-1.74), or psoriasis (hazard ratio, 1.57; 95% CI, 0.61-4.09) compared with those who received conventional systemic therapy, but the differences were not statistically significant. Adjustment for other risk factors was absent from most studies. CONCLUSIONS AND RELEVANCEThe findings suggest that clinically important increases in melanoma risk in patients treated with biologic therapy for common inflammatory diseases cannot be ruled out based on current evidence. However, further studies with large patient numbers that adjust for key risk factors are needed to resolve the issue of long-term safety of biologic therapy.

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Safety of biologics in psoriasis

Cited by 106 publications

References 118 publications

Efficacy and Safety of Biologics for Psoriasis and Psoriatic Arthritis and Their Impact on Comorbidities: A Literature Review

Efficacy and Safety of Biologics for Psoriasis and Psoriatic Arthritis and Their Impact on Comorbidities: A Literature Review

How can we manage the safety concerns associated with the increase in biologics for psoriasis?

Melanoma Risk in Patients Treated With Biologic Therapy for Common Inflammatory Diseases

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