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Results of switching of biologics in psoriasis
The efficacy and safety of biologics in the treatment of moderate to severe psoriasis have been established. However, inefficacy or unforeseen adverse events sometimes demand changing the treatment to other biologics. A study in the Journal of Dermatology examined the effectiveness of this strategy.
Researchers retrospectively investigated cases that required a switch in biologics for the treatment of psoriasis. The study enrolled 275 psoriatic patients treated with biologics between January 2010 and December 2014. Of these, 51 required a switch to another biologic. First‐line therapies were infliximab (26), adalimumab (18) and ustekinumab (seven), and second‐line therapies were infliximab (five), adalimumab (21) and ustekinumab (25).
Reasons for switching were inefficacy (38), adverse events (11) and others (two). The details were primary failure (15), secondary failure (23) and infusion reactions (eight).
In 49 patients who switched biologics due to inefficacy and adverse events, the mean Psoriasis Area and Severity Index score at week 16 was 4.3 for first‐line therapies and 2.9 for second‐line therapies.
The study concluded that switching to a second biologic therapy to address the first’s inefficacy or adverse events often results in significant improvement in moderate to severe psoriasis.
Honda, H. , Umezawa, Y. , Kikuchi, S. , Yanaba, K. , Fukuchi, O. , Ito, T. , Nobeyama, Y. , Asahina, A. and Nakagawa, H. (2017), Switching of biologics in psoriasis: Reasons and results. J Dermatol, 44: 1015-1019. doi:10.1111/1346-8138.13860
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