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Switching of biologics in psoriasis: Reasons and results
Author(s) -
Honda Hiromi,
Umezawa Yoshinori,
Kikuchi Sota,
Yanaba Koichi,
Fukuchi Osamu,
Ito Toshihiro,
Nobeyama Yoshimasa,
Asahina Akihiko,
Nakagawa Hidemi
Publication year - 2017
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.13860
Subject(s) - medicine , ustekinumab , adalimumab , adverse effect , infliximab , psoriasis , psoriasis area and severity index , dermatology , first line , disease
Efficacy and safety profiles of biologics have been established for moderate to severe psoriasis. However, inefficacy or adverse events sometimes require changing the treatment to other biologics. Here, we examine the effectiveness of this strategy. We retrospectively investigated cases requiring switching biologics. We enrolled 275 psoriatic patients treated with biologics between January 2010 and December 2014 in our hospital. Of these, 51 required a switch to another biologic. First‐line therapies were infliximab ( IFX , n = 26), adalimumab ( ADA , n = 18) and ustekinumab ( UST , n = 7), and second‐line therapies were IFX ( n = 5), ADA ( n = 21) and UST ( n = 25). Reasons for switching were inefficacy ( n = 38), adverse events ( n = 11) and others ( n = 2). The details were primary failure ( n = 15 ), secondary failure ( n = 23) and infusion reactions ( n = 8). In 49 patients who switched biologics due to inefficacy and adverse events, the mean Psoriasis Area and Severity Index ( PASI ) score at week 16 was 4.3 for first‐line therapies and 2.9 for second‐line therapies ( P < 0.05 ). 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.