title: Effectiveness of Biologic and Conventional Systemic Therapies in Adults with Chronic Plaque Psoriasis in Daily Practice: A Systematic Review.
abstract: The efficacy of biologic or conventional systemic therapies for psoriasis has been shown in randomized controlled trials. Effectiveness, however, has been studied in daily practice cohorts, and no aggregation of effectiveness data is available. This systematic review searched PubMed and EMBASE and summarized the real-world evidence on effectiveness of biologics (adalimumab, etanercept, infliximab and ustekinumab) and conventional systemic therapies (acitretin, cyclosporine, fumarates and methotrexate) for the treatment of plaque psoriasis in adults. Thirty-two studies were included. Few data were available on infliximab, ustekinumab and conventional systemics. Results show that biologics and conventional systemics were effective in real-life treatment of psoriasis, with large ranges in the percentage of patients reaching 75% improvement in psoriasis area and severity index score compared with baseline, especially for etanercept and adalimumab treatment. Combination therapies of biologics with conventional systemics, and dose adjustments of biologics were frequently applied strategies and may explain the large range in improvements between cohorts.
authors.affiliation: Department of Dermatology 370, Radboud University Medical Centre, René Descartesdreef 1, PO Box 9101, 6500 HB Nijmegen, The Netherlands. jeffrey_zweegers@hotmail.com.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Zweegers
authors.forename: Marisol E
authors.initials: ME
authors.lastname: Otero
authors.forename: Juul M P A
authors.initials: JM
authors.lastname: van den Reek
authors.forename: Paula P
authors.initials: PP
authors.lastname: van Lümig
authors.forename: Rieke J
authors.initials: RJ
authors.lastname: Driessen
authors.forename: Wietske
authors.initials: W
authors.lastname: Kievit
authors.forename: Marieke M B
authors.initials: MM
authors.lastname: Seyger
authors.forename: Peter C M
authors.initials: PC
authors.lastname: van de Kerkhof
authors.forename: Elke M G J
authors.initials: EM
authors.lastname: de Jong
mesh_terms: D000328:Adult; D001688:Biological Products / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D011565:Psoriasis / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001688:Biological Products; D007166:Immunosuppressive Agents