Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis

Sbidian, É.; Chaimani, Anna; García‐Doval, I.; Doney, Liz; Dressler, Corinna; Hua, Camille; Hughes, Carolyn; Naldi, Luigi; Afach, Sivem; Cléach, L. Le

doi:10.1002/14651858.cd011535.pub5

Cited by 44 publications

(29 citation statements)

References 627 publications

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“…49 A recent network meta-analysis of 167 studies reported the proportion of patients with psoriasis that reached 90% improvement on psoriasis area and severity index (PASI90) during the induction phase (8-24 weeks after randomisation) of various systemic treatments compared with controls. 25 Of all the anti-TNFs assessed, infliximab was found to have the highest probability of leading to PASI90 relative to placebo (RR: 50.19), followed by adalimumab (RR: 17.35), certolizumab pegol (RR: 13.30), and etanercept (RR: 10.65). 25 Another meta-analysis reported the efficacy of anti-TNFs with longerterm treatment, the number needed to treat to achieve PASI90 at 48 or 52 weeks was reported as adalimumab (2.17) certolizumab pegol (1.72), and etanercept (3.20).…”

Section: Psoriasismentioning

confidence: 95%

“…25 Of all the anti-TNFs assessed, infliximab was found to have the highest probability of leading to PASI90 relative to placebo (RR: 50.19), followed by adalimumab (RR: 17.35), certolizumab pegol (RR: 13.30), and etanercept (RR: 10.65). 25 Another meta-analysis reported the efficacy of anti-TNFs with longerterm treatment, the number needed to treat to achieve PASI90 at 48 or 52 weeks was reported as adalimumab (2.17) certolizumab pegol (1.72), and etanercept (3.20). 50 Adalimumab and etanercept are also approved for use in paediatric patients with psoriasis.…”

Section: Psoriasismentioning

confidence: 95%

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The Efficacy of Anti-TNFs in Immune-Mediated Disease

Humphry¹

2022

EMJ Gastroenterol

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TNF-α is produced in high concentrations in chronic inflammatory disease, resulting in excessive inflammation which eventually leads to organ damage. The advent of anti-TNF therapy in clinical practice 20 years ago represented a significant change in the management of immune-mediated inflammatory diseases (IMIDs), including rheumatoid arthritis (RA), axial spondylarthritis (SpA), psoriasis, and inflammatory bowel disease (IBD). There are five anti-TNFs approved for use in IMIDs: infliximab, adalimumab, golimumab, etanercept, and certolizumab pegol. The structural and pharmacological differences between these agents mean that they can have differential efficacy across IMIDs, and therefore the indications for which they are approved vary. This mini-review aims to summarise the current understanding of anti-TNF efficacy in those IMIDs for which they are approved, focussing on data from meta-analyses of randomised clinical trials (RCTs), and real-world studies.

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Section: Psoriasismentioning

confidence: 95%

Section: Psoriasismentioning

confidence: 95%

The Efficacy of Anti-TNFs in Immune-Mediated Disease

Humphry¹

2022

EMJ Gastroenterol

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“…Treatments were ranked from the most to least efficacious according to SUCRA: infliximab (risk ratio (RR) 50.19, 95% confidence interval (CI) 20.92 to 120.45), bimekizumab (RR 30.27, 95% CI 25.45 to 36.01), ixekizumab (RR 30.19, 95% CI 25.38 to 35.93), and risankizumab (RR 28.75, 95% CI 24.03 to 34.39 In addition, infliximab, all four IL-17 inhibitors, risankizumab, and guselkumab achieved a higher PASI90 than ustekinumab, etanercept, adalimumab, and certolizumab. 23 …”

Section: Advantages/disadvantagesmentioning

confidence: 99%

Review of bimekizumab in the treatment of psoriasis

Koppu

Singh

Kaur

et al. 2022

Human Vaccines & Immunotherapeutics

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Bimekizumab, a selective interleukin (IL) 17 inhibitor, is an emerging systemic treatment for moderate-to-severe psoriasis. Although IL-19, IL-22, and IL-36 are implicated in the pathogenesis of psoriasis, IL-17 drives the activation of these interleukins and the formation of psoriatic plaques. This review assesses the efficacy, safety, and implications of bimekizumab in the treatment of moderate-to-severe psoriasis. A review of literature was conducted using the PubMed repository in March 2022. Articles in English discussing the use of bimekizumab in the treatment of psoriasis were included. One phase II and four phase III trials were included. During clinical trials, bimekizumab was more efficacious, when compared to placebo, ustekinumab, adalimumab, and secukinumab in the treatment of moderate to severe psoriasis. Bimekizumab is a promising, efficacious, and relatively tolerable emerging systemic treatment for moderate-to-severe plaque psoriasis.

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“…L’outcome primario, PASI 90, è stato valutato a 12 settimane per la fase di induzione, così come quello secondario, PASI 75, che ancora oggi rappresenta l’indicatore da raggiungere per definire una terapia efficace, come riportato nelle Linee Guida della psoriasi della regione Emilia-Romagna ( 12 ). Entrambi gli outcome sono stati esplorati nell’analisi di scenario a 52 settimane per la fase di induzione e mantenimento, assumendo per quest’ultima la stessa efficacia della fase di induzione riportata nella network meta-analisi (NMA) Cochrane di Sbidian et al ( 15 ). Tale assunzione, validata da un panel di esperti, anche se non supportata da dati di comparazione indiretta, è in linea con i dati di efficacia clinica a 52 settimane del metotrexato e dei farmaci biologici riportati rispettivamente in Reich et al ( 16 ) e Leonardi et al ( 17 ).…”

Section: Metodiunclassified

“…L’efficacia delle terapie considerate in questo studio per il trattamento della PsO moderata-grave è stata valutata a 8-24 settimane, sulla base della stima del rischio relativo (RR) di ciascun trattamento versus placebo di raggiungere il PASI 90 e il PASI 75 riportato nella network meta-analisi (NMA) Cochrane di Sbidian et al ( 15 ) ( Tab. IV ).…”

Section: Metodiunclassified

Cost per responder for methotrexate versus other therapies in patients with moderate-to-severe plaque psoriasis in Italy

Pompilio

Integlia

2022

Grhta

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Objective: Conventional synthetic disease modifying antirheumatic drugs (csDMARDs) were recommended in 2019 as first line therapy from Italian Medicines Agency (AIFA) for the treatment of moderate to severe psoriasis. Updated local guidelines recommended methotrexate (MTX) as the drug of first choice. Nevertheless, MTX is reported by AIFA to be underused. Since no study evaluated jointly the first-line efficacy and costs of the most widely used biologic drugs (adalimumab, etanercept, secukinumab and ustekinumab) and methotrexate in Italy, a cost per responder (CPR) analysis was performed. Methods: A CPR model was developed based on efficacy data from a published Cochrane network meta-analysis.Drug costs included in the model were estimated based on average regional tender prices. The primary analysisassessed the CPR of both Psoriasis Area and Severity Index (PASI) 90 at weeks 12 and 52. A secondary analysis was conducted considering PASI 75. For methotrexate, both an average dosage of 13.4 mg, estimated by an expertpanel, and a dosage of 15 mg reported in European guidelines were considered. Results: At weeks 12 and 52, the costs per responder PASI 90 were lower for methotrexate 13.4 mg compared to the most widely used biologics in Italy, € 566.71 and € 2,455.72 respectively. Methotrexate also showed a lowest CPR both at 12 and 52 weeks, € 529.95 and € 2,296.47 respectively, in the secondary analysis. Conclusions: The analysis showed a lower cost per responder for methotrexate than for adalimumab, etanercept,secukinumab and ustekinumab. For healthcare budget holders, this means using the saved resources to treat more patients.

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Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis

Abstract: Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis (Review)

Cited by 44 publications

References 627 publications

The Efficacy of Anti-TNFs in Immune-Mediated Disease

The Efficacy of Anti-TNFs in Immune-Mediated Disease

Review of bimekizumab in the treatment of psoriasis

Cost per responder for methotrexate versus other therapies in patients with moderate-to-severe plaque psoriasis in Italy

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