[Biologic therapies in the treatment of psoriasis].
Psoriasis impairs significantly the quality of life. Systemic treatments have inconstant efficiency and dose-dependant toxicity. Since 2004, four biologic therapies - infliximab, etanercept, éfalizumab and adalimumab - are approved in Europe for the treatment of moderate to severe psoriasis, with failure, intolerance or contra-indication to at least 2 "classical" systemic treatments, including phototherapy, methotrexate and ciclosporin. The estimated rate of patients reaching PASI75 at month 3 are as follow: about 80% under infliximab (classical W0-W2-W6 regimen); about 33% and 50% under etanercept, respectively, 25 and 50mg, twice weekly; about 25% under éfalizumab (1mg/kg, weekly); about 70% under adalimumab (40mg, every other week). The 12-month efficiency of biologic therapies in psoriasis is poorly documented. The long term (5-year or more) safety of biologic therapies is not documented. New biologic therapies are under investigation in the treatment of psoriasis: ustekinumab (CNTO-1275), ABT-874, certolizumab (CDP-870), golimumab (CNTO-148). Ustekinumab is approved in Europe since January 2009.
Farhi
David
D
Service de dermatologie et de vénéréologie, Pavillon Tarnier, Hôpital Cochin, AP-HP, Université René Descartes, F-75006 Paris, France. david.farhi@cch.aphp.fr
Dupin
Nicolas
N
D000068879:Adalimumab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000068582:Certolizumab Pegol; D003879:Dermatologic Agents / Q000627:therapeutic use*; D000068800:Etanercept; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D007074:Immunoglobulin G / Q000627:therapeutic use; D000069285:Infliximab; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011565:Psoriasis / Q000188:drug therapy* / Q000523:psychology; D011788:Quality of Life; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D000069549:Ustekinumab
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D003879:Dermatologic Agents; D007140:Immunoglobulin Fab Fragments; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D011092:Polyethylene Glycols; C529000:golimumab; D000069285:Infliximab; D000069549:Ustekinumab; D000068879:Adalimumab; D000068800:Etanercept; D000068582:Certolizumab Pegol; C472181:efalizumab