Efficacy and safety of biologics in the treatment of moderate to severe psoriasis: a comprehensive meta-analysis of randomized controlled trials.
We conducted a systematic review and metaanalysis of randomized placebo-controlled trials in moderate-to-severe psoriasis treated with biological agents, with a follow-up of 10-14 weeks. Overall, 41 studies, with mean Jadad score of 4.4, and 15,586 patients were included. For the efficacy outcomes PASI 50, 75 and 90 our findings are not conclusive to point what biological agent has the greatest response in short term follow-up. There were no statistical differences between placebo and biologics for the occurrence of infections and serious adverse events. Ustekinumab 45 mg showed lower withdrawal due to adverse events compared with the placebo. Based on data available up to now, it is not possible to determine which biological agent is the best for PASI 50, 75 or 90 after 10-14 weeks of treatment. At the same follow-up, overall safety seems to be the same for all biological agents and Ustekinumab 45 mg the most well tolerated drug. To better understand efficacy and safety, indirect meta-analysis comparing drug-to-drug is required since randomized placebo-controlled trials may not be feasible.
Universidade Federal do Paraná, Curitiba, Brasil. cassyano.correr@gmail.com
Cassyano Januário
CJ
Correr
Universidade Federal do Paraná, Curitiba, Brasil.
Inajara
I
Rotta
Universidade Federal do Paraná, Curitiba, Brasil.
Thaís de Souza
Tde S
Teles
Universidade Federal do Paraná, Curitiba, Brasil.
Rangel Ray
RR
Godoy
Universidade Federal do Paraná, Curitiba, Brasil.
Bruno Salgado
BS
Riveros
Universidade Federal do Paraná, Curitiba, Brasil.
Mariana Martins
MM
Garcia
Universidade Federal do Paraná, Curitiba, Brasil.
Patrícia Rodrigues
PR
Gonçalves
Universidade Federal do Paraná, Curitiba, Brasil.
Michel Fleith
MF
Otuki
D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D011565:Psoriasis / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D000069549:Ustekinumab
D061067:Antibodies, Monoclonal, Humanized; D000069549:Ustekinumab