Abstract
The choice of treatment for psoriasis depends on the severity of the disease, while the main target of almost all systemic treatments for psoriasis is the immune system. The introduction of biologics has brought an important therapeutic improvement for psoriasis. Biologics are a heterogeneous group of monoclonal antibodies, fusion proteins and recombinant cytokines that modify and regulate pivotal and specific mechanisms involved in psoriasis immunopathogenesis, showing high efficacy and a good safety profile. At present, there are ten biologics available for the treatment of psoriasis: four anti-tumor necrosis factor alfa (TNFα) agents (adalimumab, certolizumab pegol, etanercept, infliximab), one anti-IL12/23 monoclonal antibody (mAb), (ustekinumab), three anti-IL17 monoclonal antibodies (brodalumab, ixekizumab, secukinumab), and three anti-IL 23 (anti-p19) monoclonal antibodies (guselkumab, risankizumab, tildrakizumab).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Notes
- 1.
According to their indication, most of the biologic drugs (adalimumab, brodalumab, ixekizumab, guselkumab, risankizumab, secukinumab) are indicated as a first-line treatment of moderate-to-severe psoriasis in patients’ candidates of systemic treatment, without needing to fail traditional therapies and/or phototherapy previously. Nevertheless, guidelines may vary among different countries.
Further Reading
Gisondi P, Girolomoni G. Biologic therapies in psoriasis: a new therapeutic approach. Autoimmun Rev. 2007;6:515–9.
Gladman D, Mease P, Ritchlin C, et al. Adalimumab for long-term treatment of psoriatic arthritis. Forty-eight week data from the adalimumab effectiveness in psoriatic arthritis trials. Arthritis Rheum. 2007;56:476–88.
Gordon KB, Langley RG, Leonardi C, et al. Clinical response to adalimumab treatment in patients with moderate to severe psoriasis: double-blind, randomized controlled trial and open-label extension study. J Am Acad Dermatol. 2006;55:598–606.
Gottlieb AB, Evans R, Li S, et al. Infliximab induction therapy for patients with severe plaque-type psoriasis: a randomized, double-blind, placebo-controlled trial. J Am Acad Dermatol. 2004;51:534–42.
Griffiths CEM, Barker JNWN. Pathogenesis and clinical features of psoriasis. Lancet. 2007;370:263–71.
Gudjonsson J, Johnston A, Ellis CN, Arbor A. Novel systemic drugs under investigation for the treatment of psoriasis. J Am Acad Dermatol. 2012;67:139–47.
Kim HJ, Lebwohl MG. Biologics and psoriasis. Dermatol Clin. 2019;37:29–36.
Krueger GG, Langley RG, Leonardi C, et al. A human interleukin-12/23 monoclonal antibody for the treatment of psoriasis. N Engl J Med. 2007;356:580–92.
Lee E, Amin M, Bhutani T, et al. Emerging therapies in psoriasis: a systematic review. Cutis. 2018;101(Suppl 3):5–9.
Leonardi CL, Powers JL, Matheson RT, et al. Etanercept as monotherapy in patients with psoriasis. N Engl J Med. 2003;349:2014–22.
Leonardi CL, Kimball AB, Papp KA, Yeilding N, Guzzo C, Wang Y, Li S, Dooley LT, Gordon KB. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 76-week results from a randomised, doubleblind, placebo-controlled trial(PHOENIX 1). Lancet. 2008;371:1665–74.
Menter A, Feldman SR, Weinstein GD, et al. A randomized comparison of continuous vs. intermittent infliximab maintenance regimens over 1 year in the treatment of moderate-to-severe plaque psoriasis. J Am Acad Dermatol. 2007;56:31.e1.
Menter A, Tyring S, Gordon K, et al. Adalimumab therapy for moderate to severe psoriasis: a randomized, controlled phase III trial. J Am Acad Dermatol. 2008;58(1):106–15. Epub 2007 Oct 23.
Mrowietz U, Kragballe K, Reich K, Spuls P, Griffiths CE, Nast A, et al. Definition of treatment goals for moderate to severe psoriasis: a European consensus. Arch Dermatol Res. 2011;303:1–10.
Nast A, Boencke WH, Mrowietz U, Ockenfels HM, Philipp S, Reich K, et al. S-3 guidelines on the treatment of psoriasis vulgaris (English version). Update. J Dtsch Dermatol Ges. 2012;10(Suppl 2):S1–S95.
Nast A, Amelunxen L, Augustin M, et al. S3 guidelines for the treatment of psoriasis vulgaris, update- short version part 1 systemic treatment. J Dtsch Dermatol Ges. 2018;16(5):645.
Papp KA, Tyring S, Lahfa M, et al. A global phase III randomized controlled trial of etanercept in psoriasis: safety, efficacy, and effect of dose reduction. Br J Dermatol. 2005;152:1304–12.
Papp KA, Langley RG, Lebwohl M, Krueger GG, Szapary P, Yeilding N, Guzzo C, Hsu MC, Wang Y, Li S, Dooley LT, Reich K. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 52-week results from a randomised, doubleblind, placebo-controlled trial (PHOENIX 2). Lancet. 2008;371:1675–84.
Pathirana D, Ormerod AD, Saiag P, Smith C, Spuls PI, Nast A, et al. European S3-guidelines on the systemic treatments of psoriasis vulgaris. J Eur Acad Dermatol Venereol. 2009;23(Suppl 2):5–70.
Reich K, Nestle FO, Papp K, et al. Infliximab induction and maintenance therapy for moderate-to-severe psoriasis: a phase III, multicentre, double-blind trial. Lancet. 2005;366:1367–74.
Ryan C, Abramson A, Patel m, Menter A. Current investigational drugs in psoriasis. Expert Opin Investig Drugs. 2012;21(4):473–87.
Saurat JH, Stingl G, Dubertret L, Papp K, Langley RG, Ortonne JP, et al. Efficacy and safety results from the comparative study of adalimumab (Humira) versus methotrexate versus placebo in psoriasis patients (CHAMPION). Br J Dermatol. 2008;158(3):558–66. Epub 2007 Nov 28, 31–15.
Schadler ED, et al. Biologics for the primary care physician: review and treatment of psoriasis. Dis Mon. 2019;65:51.
Smith CH, Anstey AV, Barker JN, Burden AD, Chalmers RJ, Chandler DA, Finlay AY, Griffiths CE, Jackson K, McHugh NJ, McKenna KE, Reynolds NJ, Ormerod AD. British Association of Dermatologists’ guidelines for biologic interventions for psoriasis 2009. Br J Dermatol. 2009;161:987–1019.
Sterry W, Barker J, Boehncke WH, Bos JD, Chimenti S, Christophers E, De La Brassinne M, Ferrandiz C, Griffiths C, Katsambas A, Kragballe K, Lynde C, Menter A, Ortonne JP, Papp K, Prinz J, Rzany B, Ronnevig J, Saurat JH, Stahle M, Stengel FM, Van De Kerkhof P, Voorhees J. Biological therapies in the systemic management of psoriasis: international consensus conference. Br J Dermatol. 2004;151(Suppl 69):3–17.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Papoutsaki, M., Antoniou, C. (2023). Biologic Agents for Psoriasis. In: Katsambas, A.D., Lotti, T.M., Dessinioti, C., D'Erme, A.M. (eds) European Handbook of Dermatological Treatments. Springer, Cham. https://doi.org/10.1007/978-3-031-15130-9_140
Download citation
DOI: https://doi.org/10.1007/978-3-031-15130-9_140
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-15129-3
Online ISBN: 978-3-031-15130-9
eBook Packages: MedicineMedicine (R0)