Infliximab, adalimumab show efficacy in psoriasis and IBD
Infliximab and adalimumab are both effective for the treatment of psoriasis, psoriatic arthritis, ulcerative colitis and Crohn’s disease, while other biologics have shown efficacy for some, but not all, of these indications, according to the results of a systematic review.
To evaluate therapeutic options for patients with psoriasis and concurrent inflammatory bowel disease (IBD), a total of 2,282 articles were identified, of which 132 were selected. These clinical studies, published from 1 January 1947 to 14 February 2017, focused on biologic and systemic psoriasis medications in psoriasis, psoriatic arthritis, ulcerative colitis and Crohn’s disease.
The investigators selected randomized, controlled, double-blinded studies if available and, if not, the next highest level of available evidence.
Both infliximab and adalimumab had shown efficacy in psoriasis, psoriatic arthritis, ulcerative colitis and Crohn’s disease. Ustekinumab was effective against psoriasis, psoriatic arthritis and Crohn’s disease, while certolizumab had demonstrated efficacy in psoriatic arthritis and Crohn’s disease.
On the other hand, etanercept, secukinumab, brodalumab and ixekizumab were effective in psoriasis and psoriatic arthritis, but these medications could induce or worsen IBD. In addition, guselkumab was effective in psoriasis only.
This systematic review was limited by the absence of clinical trials involving treatment specifically for concurrent psoriasis and IBD.
“There is a significant association between psoriasis and IBD. Many treatments for psoriasis and psoriatic arthritis are also used for IBD,” according to the investigators.
In another systematic review, researchers found that biologic therapy was effective and safe for the treatment of hyperkeratotic palmoplantar psoriasis (PP). [Dermatol Ther (Heidelb) 2017;7:425-446]
“Adalimumab, guselkumab, ixekizumab, secukinumab and ustekinumab all showed >80-percent efficacy for the treatment of hyperkeratotic PP, while infliximab and ustekinumab showed moderate efficacy for the treatment of pustular PP, and infliximab was the most efficacious treatment for palmoplantar pustulosis,” they said.