title: Practical guidance on immunogenicity to biologic agents used in the treatment of psoriasis: What can be learnt from other diseases?
abstract: The clinical efficacy of biologic agents for the treatment of moderate to severe psoriasis is well proven in clinical studies, but patients may lose response over time. Loss of response may be due to immunogenicity and the formation of anti-drug antibodies (ADA). Although data on the immunogenicity of drugs used to treat psoriasis are now emerging, more information on the impact of factors, such as dosing regimens and concomitant immunosuppressive therapy is needed. Exploring research from other disease areas where immunogenicity has long been recognised as a significant clinical issue may help in developing future strategies for using drug level and ADA measurements to help tailor biologic therapy to meet individual needs. To this end, we analyse what is known about biologics and immunogenicity in psoriasis. In order to learn from other indications, we then address the issue of immunogenicity for three different types of biologic treatments. First, factor VIII-substitution in haemophilia, where the immune system is newly exposed to a physiologic but formerly absent protein. Second, the use of biologics in inflammatory bowel disease, where similar treatment challenges apply as observed in psoriasis. Third, immunogenicity in multiple sclerosis caused by therapeutic antibodies or interferons. Immunogenicity strategies used in other disease areas will need to be tested in psoriasis before they can be widely adopted in routine clinical practice.
authors.affiliation: a Department of Dermatology , Ghent University Hospital , Ghent , Belgium .
authors.forename: Jo
authors.initials: J
authors.lastname: Lambert
authors.affiliation: b Division of Evidence Based Medicine (dEBM), Department of Dermatology, Venerology and Allergy , Charité - Universitätsmedizin Berlin , Berlin , Germany .
authors.forename: Alexander
authors.initials: A
authors.lastname: Nast
authors.affiliation: c St. John's Institute of Dermatology, King's College London School of Medicine , London , UK , and.
authors.forename: Frank O
authors.initials: FO
authors.lastname: Nestle
authors.affiliation: d Clinic and Policlinic for Dermatology and Allergology, Ludwig-Maximilian-University , Munich , Germany.
authors.forename: Jörg C
authors.initials: JC
authors.lastname: Prinz
mesh_terms: D001685:Biological Factors / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000188:drug therapy; D011565:Psoriasis / Q000188:drug therapy*
chemical_list: D001685:Biological Factors; D007166:Immunosuppressive Agents
keywords: Anti-drug antibodies; biologic; immunogenicity; psoriasis