Severe and acute complications of biologics in psoriasis.

Abstract

Biologic therapies have revolutionized the approach to immune-mediated diseases such as psoriasis. Due to their favorable safety profiles and excellent efficacy, biologic agents are considered the gold standard for moderate-to-severe psoriasis. The aim of this paper is to saliently review the severe and acute complications of the Food and Drug Administration (FDA) approved biologic agents for psoriasis. Reviewed agents include tumor necrosis factor alpha inhibitors (etanercept, infliximab, and adalimumab), interleukin 12/23 inhibitors (ustekinumab), and interleukin 17 (IL-17) inhibitors (secukinumab and ixekizumab). While malignancies, serious infections, and major adverse cardiovascular events have been reported, their association with biologic therapy are not hypothesized as causal. However, IL-17 inhibitors appear to cause exacerbations and new cases of inflammatory bowel disease. While more long-term studies are warranted in understanding the biologic's long-term side effect profile, short-term studies have confirmed that the biologics are some of the safest treatment options for psoriasis. Nevertheless, certain populations yield higher risk to acute complications with the biologics than others - physicians must use their judgement and vigilance when monitoring and treating patients undergoing therapy with biological agents.

• Authors: Elias Oussedik, Nupur U Patel, Devin R Cash, Angela S Gupta, Steven R Feldman
• Journal: Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia (G Ital Dermatol Venereol) Vol. 152 Issue 6 Pg. 586-596 (Dec 2017) ISSN: 1827-1820 [Electronic] Italy
• PMID: 28895664 (Publication Type: Journal Article, Review)

Chemical References

• Biological Factors
• Dermatologic Agents
• Tumor Necrosis Factor-alpha

Topics

• Animals
• Biological Factors (adverse effects, therapeutic use)
• Dermatologic Agents (adverse effects, therapeutic use)
• Drug Monitoring (methods)
• Humans
• Psoriasis (drug therapy, immunology, pathology)
• Severity of Illness Index
• Time Factors
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)