title: Biologic therapy with or without topical treatment in psoriasis: what does the current evidence say?
abstract: Biologic therapy represents a relatively new class of drugs which have revolutionized the treatment of psoriasis and are used with increasing frequency in order to control this chronic, systemic inflammatory disease. However, it is unclear what role there is for combination therapy of biologics with traditional topical agents. The purpose of this article is to assess the literature on the role of topical agents as adjuvants to biological treatments in the treatment of psoriasis and identify areas for further research. A MEDLINE search was performed in order to identify English-language publications from 1996 to 2014 examining combination biologic therapy with topical medications in the treatment of psoriasis. Data from these clinical studies are summarized and the outcomes are discussed. In general, the addition of adjuvant topical therapy to systemic biologic therapy allowed for a reduction in dosage and side effects of both agents, maintenance of initial response to biologics, treatment of recalcitrant lesions in partial responders, and potential acceleration of response to biologic therapies. The current data, though limited, suggest that using topical therapies as adjunct treatment to biologics is a well tolerated and effective means of controlling psoriasis and improving quality of life for patients. However, the treating physician should remain attentive to signs of adverse events and seek opportunities to reduce the dose or treatment frequency during chronic use.
authors.affiliation: Department of Dermatology, University of Alabama at Birmingham, EFH 414, 1530 3rd Ave, South Birmingham, AL, 35294-0009, USA.
authors.forename: J Daniel
authors.initials: JD
authors.lastname: Jensen
authors.forename: Macey Renault
authors.initials: MR
authors.lastname: Delcambre
authors.forename: Gloria
authors.initials: G
authors.lastname: Nguyen
authors.forename: Naveed
authors.initials: N
authors.lastname: Sami
mesh_terms: D000279:Administration, Cutaneous; D001688:Biological Products / Q000008:administration & dosage / Q000627:therapeutic use*; D001691:Biological Therapy / Q000379:methods; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D007155:Immunologic Factors; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology; D011788:Quality of Life
chemical_list: D001688:Biological Products; D003879:Dermatologic Agents; D007155:Immunologic Factors