Long-term safety of biologics in the treatment of moderate-to-severe plaque psoriasis: review of current data

Authors


  • Funding sources
    Editorial support for this article was funded by Janssen. Editorial control resided with the author. The author received no honoraria or other form of financial support related to the development of this manuscript. Financial support for publication of this supplement was provided by Janssen.

  • Conflicts of interest
    M.H.A.R. has been involved in clinical trials of all the biologicals mentioned in this review, has received honoraria for speaking at meetings organized by Janssen-Cilag and has received sponsorship from Schering-Plough, Abbott and Janssen-Cilag to attend scientific meetings.

M.H.A. Rustin.
E-mail: malcolmrustin@btinternet.com

Summary

Conventional non-biologic systemic agents are regarded as second-line therapy for the treatment of moderate-to-severe plaque psoriasis after topical treatments. However, long-term data have highlighted a number of safety concerns associated with their prolonged use. Biologic agents targeting specific immune mediators have emerged as an alternative treatment option for patients with moderate-to-severe plaque psoriasis who are unresponsive to, or intolerant of, non-biologic systemic agents. Although several biologics have demonstrated good efficacy and tolerability in short-term trials, treatment guidelines recommend them as third-line therapies due to a relative lack of long-term safety data. Here, we have reviewed the long-term (≥ 1 year) safety data from randomized controlled trials, open-label extension studies and meta-analyses of etanercept, infliximab, efalizumab, adalimumab, alefacept and ustekinumab in the treatment of adults with moderate-to-severe plaque psoriasis. With the exception of efalizumab, which has been withdrawn from both the European and U.S. markets due to long-term safety concerns, these biologics are generally well tolerated in long-term studies, and offer a viable alternative to conventional non-biologic agents in patients with moderate-to-severe plaque psoriasis.

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