title: An update on drug-drug interactions with biologics for the treatment of moderate-to-severe psoriasis.
abstract: OBJECTIVE
  Moderate-to-severe psoriasis is a chronic skin condition that often requires systemic therapy and biologics are the newest systemic treatment available. A favorable aspect of biologics is that they are thought to have minimal risks for drug-drug interactions compared to oral systemic medications such as cyclosporine and methotrexate. However, this assumption has not been recently or adequately reviewed. We reviewed the literature to identify possible drug-drug interactions with biologics and other medications.
  
  
  METHODS
  We searched PubMed for published case reports, clinical studies, reviews, and Food and Drug Administration (FDA) labels discussing possible drug-drug interactions with biologics for the treatment of moderate-to-severe psoriasis.
  
  
  RESULTS
  There were only a small number of published articles describing drug-drug interactions with biologics. Our review identified two case reports, five clinical studies, and three pharmacokinetics reviews. The majority of articles did not observe clinically relevant drug-drug interactions with biologics. FDA labels do suggest a possible relationship between tumor necrosis factor (TNF)-alpha inhibitors and cytochrome P450 (CYP) activity.
  
  
  CONCLUSIONS
  The paucity of information regarding drug-drug interactions reaffirms the idea that biologics have limited susceptibility to drug-drug interactions compared to other oral medications. Further studies are needed to adequately assess drug-drug interactions with biologics.
authors.affiliation: Keck School of Medicine of University of Southern California , Los Angeles, CA , USA.
authors.forename: Rishu
authors.initials: R
authors.lastname: Gupta
authors.forename: Ethan
authors.initials: E
authors.lastname: Levin
authors.forename: Jashin J
authors.initials: JJ
authors.lastname: Wu
authors.forename: John
authors.initials: J
authors.lastname: Koo
authors.forename: Wilson
authors.initials: W
authors.lastname: Liao
mesh_terms: D000068879:Adalimumab; D000911:Antibodies, Monoclonal / Q000494:pharmacology; D061067:Antibodies, Monoclonal, Humanized / Q000494:pharmacology; D001688:Biological Products / Q000494:pharmacology*; D016572:Cyclosporine / Q000627:therapeutic use; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D004347:Drug Interactions; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000494:pharmacology; D000069285:Infliximab; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D011565:Psoriasis / Q000473:pathology / Q000628:therapy*; D018124:Receptors, Tumor Necrosis Factor / Q000037:antagonists & inhibitors*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000627:therapeutic use; D014481:United States; D000069549:Ustekinumab
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D016572:Cyclosporine; D003577:Cytochrome P-450 Enzyme System; D000069285:Infliximab; D000069549:Ustekinumab; D000068879:Adalimumab; D000068800:Etanercept; D008727:Methotrexate