title: The Role of Biologic Therapies in Dermatology.
abstract: Biologic therapy has dramatically changed the way medicine, and specifically dermatology, is practiced today. The use of biologic agents in dermatology is evolving, with psoriasis being the most common indication for which biologics are used currently. However, several other dermatologic diseases seem to be responsive to biologic therapy, and continuing research and development efforts are elucidating the benefit-risk profiles of various biologic medications in these dermatologic conditions. Although biologic agents have revolutionized the management of dermatologic conditions, cost must also be considered when evaluating management options, especially compared with traditional agents. For example, the cost of 1 year of induction and maintenance treatment of psoriasis in 2014 was estimated to be $53,909 for ustekinumab, $46,395 for etanercept, and $39,041 for adalimumab. Nonetheless, because of their efficacy, the cost of a biologic may be offset by significant reductions in the number of hospital stays, reduction in use of other systemic therapies, and increased satisfaction by patients.32 Thus, understanding their mechanisms of action, labeled and off-label uses in dermatology, and common adverse effects helps to inform clinical decision making and improve patient outcomes.
authors.affiliation: Department of Dermatology, University of Colorado Denver, 1665 Aurora Court, Room 3234, Mail Stop F703, Aurora, CO 80045, USA. Electronic address: ramin.fathi@ucdenver.edu.
authors.forename: Ramin
authors.initials: R
authors.lastname: Fathi
authors.affiliation: Department of Dermatology, University of Colorado Denver, 1665 Aurora Court, Room 3234, Mail Stop F703, Aurora, CO 80045, USA.
authors.forename: April Wang
authors.initials: AW
authors.lastname: Armstrong
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D003879:Dermatologic Agents / Q000627:therapeutic use*; D000068800:Etanercept / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D000069285:Infliximab / Q000627:therapeutic use; D007378:Interleukins / Q000037:antagonists & inhibitors; D000069283:Rituximab / Q000627:therapeutic use; D012871:Skin Diseases / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D000069549:Ustekinumab / Q000627:therapeutic use
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D003879:Dermatologic Agents; D016756:Immunoglobulins, Intravenous; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha; D000069283:Rituximab; D000069285:Infliximab; C555450:secukinumab; D000069549:Ustekinumab; D000068879:Adalimumab; D000068800:Etanercept
keywords: Adalimumab; Biologics; Dermatology; Etanercept; IVIG; Infliximab; Secukinumab; Ustekinumab