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Sequential use of biologics in the treatment of moderate‐to‐severe plaque psoriasis
Author(s) -
Leman J.,
Burden A.D.
Publication year - 2012
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.2012.11209.x
Subject(s) - medicine , ustekinumab , adalimumab , etanercept , infliximab , psoriasis , secukinumab , plaque psoriasis , tolerability , dermatology , dalbavancin , oncology , adverse effect , tumor necrosis factor alpha , psoriatic arthritis , genetics , vancomycin , biology , bacteria , staphylococcus aureus
Summary A number of biologic agents, including the tumour necrosis factor (TNF) antagonists etanercept, adalimumab and infliximab, and the interleukin (IL)‐12/IL‐23 antagonist ustekinumab, are available for the treatment of moderate‐to‐severe plaque psoriasis in the U.K. Currently, the selection of the first biologic, and the choice of sequential biologics in the event of efficacy/tolerability concerns, is made using a limited evidence base. The efficacy of biologics, the potential mechanisms of primary and secondary failure and the evidence for sequencing therapy among TNF antagonists and between TNF antagonists and IL‐12/IL‐23 blockade are reviewed. As psoriasis biologics registers begin to produce long‐term safety and efficacy data, therapy decisions in plaque psoriasis may become more objective, and it may be possible to individualize treatment based on clinical or pharmacogenetic information.