Comparison of Biologics and Oral Treatments for Plaque Psoriasis | Dermatology | JN Learning | AMA Ed Hub [Skip to Content]
[Skip to Content Landing]

Comparison of Biologics and Oral Treatments for Plaque PsoriasisA Meta-analysis

Educational Objective
To examine relative short-term and long-term efficacy of biologics and oral agents for the treatment of moderate to severe psoriasis
1 Credit CME
Key Points

Question  What is the short-term and long-term comparative efficacy among biologics and oral agents for plaque psoriasis?

Findings  In a network meta-analysis of 60 clinical trials for short-term efficacy, brodalumab, guselkumab, ixekizumab, and risankizumab-rzaa had the highest Psoriasis Area and Severity Index response rates at 10 to 16 weeks from baseline. A meta-analysis of long-term efficacy suggested that brodalumab, guselkumab, ixekizumab, and risankizumab-rzaa had the highest response rates at 44 to 60 weeks.

Meaning  This study provides an assessment of both short-term and long-term comparative efficacy among treatments for moderate to severe plaque psoriasis which can help health care stakeholders optimize treatment regimens.

Abstract

Importance  The clinical benefits of novel treatments for moderate to severe psoriasis are well established, but wide variations exist in patient response across different therapies. In the absence of head-to-head randomized trials, meta-analyses synthesizing data from multiple studies are needed to assess comparative efficacy among psoriasis treatments.

Objective  To estimate the relative short-term and long-term efficacy of biologics and oral agents for the treatment of moderate to severe psoriasis.

Data Sources  A systematic literature review was conducted on December 4, 2017, and updated on September 17, 2018. The Embase, MEDLINE, and Cochrane Central Register databases were included.

Study Selection  Phase 2, 3, or 4 randomized clinical trials of treatments licensed by the US Food and Drug Administration and the European Medicines Agency for adults with moderate to severe psoriasis with data on Psoriasis Area and Severity Index assessment of 75%, 90%, and 100% reductions (PASI 75, 90, and 100) at 10 to 16 weeks (short-term efficacy) or 44 to 60 weeks (long-term efficacy) from baseline.

Data Extraction and Synthesis  Data were extracted based on the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. A bayesian network meta-analysis was conducted to estimate short-term PASI response rates; to account for variation across trials, an ordinal model that adjusted for reference arm response was implemented. The long-term PASI rates were estimated via a traditional meta-analysis.

Main Outcomes and Measures  PASI 75, 90, and 100 response rates at 10 to 16 weeks and 44 to 60 weeks from baseline.

Results  Sixty trials meeting all inclusion criteria were included. At weeks 10 to 16, the highest PASI 90 rates were seen with risankizumab-rzaa (71.6%; 95% credible interval [CrI], 67.5%-75.4%), brodalumab (70.8%; 95% CrI, 66.8%-74.6%), ixekizumab (70.6%; 95% CrI, 66.8%-74.6%), and guselkumab (67.3%; 62.5%-71.9%). At weeks 44 to 60, the treatments with the highest PASI 90 rates were risankizumab-rzaa (79.4%, 95% CI, 75.5%-82.9%), guselkumab (76.5%; 95% CI, 72.1%-80.5%), brodalumab (74.0%; 95% CI, 69.3%-78.1%), and ixekizumab (73.9%; 95% CI, 69.9%-77.5%). Findings were consistent for short-term and long-term PASI 75 and 100 responses.

Conclusions and Relevance  This study provides an assessment of the comparative efficacy among treatments for moderate to severe plaque psoriasis. The meta-analysis suggests that brodalumab, guselkumab, ixekizumab, and risankizumab-rzaa were associated with the highest PASI response rates in both short-term and long-term therapy.

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 CME Credit™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: October 25, 2019.

Corresponding Author: April W. Armstrong, MD, MPH, Department of Dermatology, Keck School of Medicine, University of Southern California, HC4 2000, 1450 San Pablo, Health Sciences Campus, Los Angeles, CA 90033 (aprilarmstrong@post.harvard.edu).

Published Online: February 5, 2020. doi:10.1001/jamadermatol.2019.4029

Author Contributions: Drs Li and Betts had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Armstrong, Joshi, Skup, Li, Betts, Augustin.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Armstrong, Joshi, Skup, Williams, Li, Betts.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Armstrong, Puig, Joshi, Li, Betts.

Administrative, technical, or material support: Joshi, Williams.

Supervision: Armstrong, Puig, Joshi, Skup, Williams, Betts, Augustin.

Conflict of Interest Disclosures: Dr Armstrong reported receiving grants and personal fees from AbbVie, Eli Lilly, Leo Pharma, and Novartis Pharmaceuticals Corp; personal fees from Boehringer Ingelheim/Parexel, Bristol-Myers Squibb, Celgene, Dermavant, Janssen Pharmaceuticals Inc, Merck, Modernizing Medicine, Ortho Dermatologics, Pfizer Inc, Regeneron Pharmaceuticals, Sanofi Genzyme, Science 37 Inc, Genentech, GlaxoSmithKline, and Valeant; and grants from Dermira, Janssen-Ortho Inc, Kyowa Hakko Kirin, and UCB Pharma outside the submitted work. Dr Puig reported receiving grants and personal fees from AbbVie during the conduct of the study; grants and personal fees from Almirall, Amgen, Boehringer Ingelheim, Celgene, Janssen, Leo-Pharma, Lilly, Novartis, Pfizer, Regeneron, Sanofi, Roche, and UCB outside the submitted work; and personal fees from Sandoz, Merck-Serono, MSD, Mylan, and Samsung-Bioepis. Dr Joshi is an employee AbbVie during the conduct of the study. Dr Skup is an employee AbbVie. Dr Williams is an of AbbVie. Dr Li reported receiving grants from AbbVie during the conduct of the study outside the submitted work. Dr Betts reported receiving consultancy fees from AbbVie Inc. during the conduct of the study. No other disclosures were reported.

Funding/Support: Design, study conduct, and financial support for the study were provided by AbbVie.

Role of the Funder/Sponsor: AbbVie participated in the interpretation of data, review, and approval of the abstract; all authors contributed to the development of the publication and maintained control over the final content.

Additional Contributions: Yan Wang, ScD, and Viviana Garcia-Horton, PhD, provided analytical support and Gloria DeWalt, PhD (Analysis Group Inc), provided editorial assistance. Analysis Group Inc received payment from AbbVie for participation in this research. Palvi Gupta, MPharm, Jatin Gupta, MPharm, and Rashi Patel, MPharm (DRG Abacus) provided support with literature search and study selection.

References
1.
Young  M, Roebuck  HL.  Apremilast, an oral phosphodiesterase 4 (PDE4) inhibitor: a novel treatment option for nurse practitioners treating patients with psoriatic disease.  J Am Assoc Nurse Pract. 2016;28(12):683-695. doi:10.1002/2327-6924.12428PubMedGoogle Scholar
2.
Kerdel  F, Zaiac  M.  An evolution in switching therapy for psoriasis patients who fail to meet treatment goals.  Dermatol Ther. 2015;28(6):390-403. doi:10.1111/dth.12267PubMedGoogle ScholarCrossref
3.
Kim  WB, Jerome  D, Yeung  J.  Diagnosis and management of psoriasis.  Can Fam Physician. 2017;63(4):278-285.PubMedGoogle Scholar
4.
Levine  D, Gottlieb  A.  Evaluation and management of psoriasis: an internist’s guide.  Med Clin North Am. 2009;93(6):1291-1303. doi:10.1016/j.mcna.2009.08.003PubMedGoogle ScholarCrossref
5.
Rønholt  K, Iversen  L.  Old and new biological therapies for psoriasis.  Int J Mol Sci. 2017;18(11):pii:E2297. doi:10.3390/ijms18112297PubMedGoogle Scholar
6.
Krueger  JG.  The immunologic basis for the treatment of psoriasis with new biologic agents.  J Am Acad Dermatol. 2002;46(1):1-23. doi:10.1067/mjd.2002.120568PubMedGoogle ScholarCrossref
7.
Amin  M, No  DJ, Egeberg  A, Wu  JJ.  Choosing first-line biologic treatment for moderate-to-severe psoriasis: what does the evidence say?  Am J Clin Dermatol. 2018;19(1):1-13. doi:10.1007/s40257-017-0328-3PubMedGoogle ScholarCrossref
8.
Haugh  IM, Preston  AK, Kivelevitch  DN, Menter  AM.  Risankizumab: an anti-IL-23 antibody for the treatment of psoriasis.  Drug Des Dev Ther. 2018;12:3879-3883. doi:10.2147/DDDT.S167149PubMedGoogle ScholarCrossref
9.
AbbVie. European Commission approves SKYRIZI (risankizumab) for the treatment of moderate to severe plaque psoriasis. https://news.abbvie.com/news/press-releases/european-commission-approves-skyrizi-risankizumab-for-treatment-moderate-to-severe-plaque-psoriasis.htm. Published April 30, 2019. Accessed June 11, 2019.
10.
Piaserico  S, Cazzaniga  S, Chimenti  S,  et al; Psocare Study Group.  Efficacy of switching between tumor necrosis factor-alfa inhibitors in psoriasis: results from the Italian Psocare registry.  J Am Acad Dermatol. 2014;70(2):257-62.e3. doi:10.1016/j.jaad.2013.10.019PubMedGoogle ScholarCrossref
11.
Lecluse  LL, Driessen  RJ, Spuls  PI,  et al.  Extent and clinical consequences of antibody formation against adalimumab in patients with plaque psoriasis.  Arch Dermatol. 2010;146(2):127-132. doi:10.1001/archdermatol.2009.347PubMedGoogle ScholarCrossref
12.
Wan  MT, Alvarez  J, Shin  DB, Dommasch  ED, Wu  JJ, Gelfand  JM.  Head-to-head trials of systemic psoriasis therapies: a systematic review of study design and maximum acceptable treatment differences.  J Eur Acad Dermatol Venereol. 2019;33(1):42-55. doi:10.1111/jdv.15174PubMedGoogle ScholarCrossref
13.
Thaçi  D, Blauvelt  A, Reich  K,  et al.  Secukinumab is superior to ustekinumab in clearing skin of subjects with moderate to severe plaque psoriasis: CLEAR, a randomized controlled trial.  J Am Acad Dermatol. 2015;73(3):400-409. doi:10.1016/j.jaad.2015.05.013PubMedGoogle ScholarCrossref
14.
Reich  K, Armstrong  AW, Langley  RG,  et al.  Guselkumab versus secukinumab for the treatment of moderate-to-severe psoriasis (ECLIPSE): results from a phase 3, randomised controlled trial.  Lancet. 2019;394(10201):831-839. doi:10.1016/S0140-6736(19)31773-8PubMedGoogle ScholarCrossref
15.
Gordon  KB, Strober  B, Lebwohl  M,  et al.  Efficacy and safety of risankizumab in moderate-to-severe plaque psoriasis (UltIMMa-1 and UltIMMa-2): results from two double-blind, randomised, placebo-controlled and ustekinumab-controlled phase 3 trials.  Lancet. 2018;392(10148):650-661. doi:10.1016/S0140-6736(18)31713-6PubMedGoogle ScholarCrossref
16.
Reich  K, Pinter  A, Lacour  JP,  et al; IXORA-S investigators.  Comparison of ixekizumab with ustekinumab in moderate-to-severe psoriasis: 24-week results from IXORA-S, a phase III study.  Br J Dermatol. 2017;177(4):1014-1023. doi:10.1111/bjd.15666PubMedGoogle ScholarCrossref
17.
Blauvelt  A, Papp  KA, Griffiths  CE,  et al.  Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the continuous treatment of patients with moderate to severe psoriasis: Results from the phase III, double-blinded, placebo- and active comparator-controlled VOYAGE 1 trial.  J Am Acad Dermatol. 2017;76(3):405-417. doi:10.1016/j.jaad.2016.11.041PubMedGoogle ScholarCrossref
18.
Reich  K, Armstrong  AW, Foley  P,  et al.  Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the treatment of patients with moderate to severe psoriasis with randomized withdrawal and retreatment: Results from the phase III, double-blind, placebo- and active comparator-controlled VOYAGE 2 trial.  J Am Acad Dermatol. 2017;76(3):418-431. doi:10.1016/j.jaad.2016.11.042PubMedGoogle ScholarCrossref
19.
Lebwohl  M, Strober  B, Menter  A,  et al.  Phase 3 studies comparing brodalumab with ustekinumab in psoriasis.  N Engl J Med. 2015;373(14):1318-1328. doi:10.1056/NEJMoa1503824PubMedGoogle ScholarCrossref
20.
Reich  K, Gooderham  M, Green  L,  et al.  The efficacy and safety of apremilast, etanercept and placebo in patients with moderate-to-severe plaque psoriasis: 52-week results from a phase IIIb, randomized, placebo-controlled trial (LIBERATE).  J Eur Acad Dermatol Venereol. 2017;31(3):507-517. doi:10.1111/jdv.14015PubMedGoogle ScholarCrossref
21.
Reich  K, Gooderham  M, Thaçi  D,  et al.  Risankizumab compared with adalimumab in patients with moderate-to-severe plaque psoriasis (IMMvent): a randomised, double-blind, active-comparator-controlled phase 3 trial.  Lancet. 2019;394(10198):576-586. doi:10.1016/S0140-6736(19)30952-3PubMedGoogle ScholarCrossref
22.
Bagel  J, Nia  J, Hashim  PW,  et al.  Secukinumab is superior to ustekinumab in clearing skin in patients with moderate to severe plaque psoriasis (16-week CLARITY results).  Dermatol Ther (Heidelb). 2018;8(4):571-579. doi:10.1007/s13555-018-0265-yPubMedGoogle ScholarCrossref
23.
Hutton  B, Salanti  G, Caldwell  DM,  et al.  The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations.  Ann Intern Med. 2015;162(11):777-784. doi:10.7326/M14-2385PubMedGoogle ScholarCrossref
24.
Dias  S, Sutton  AJ, Ades  AE, Welton  NJ.  Evidence synthesis for decision making 2: a generalized linear modeling framework for pairwise and network meta-analysis of randomized controlled trials.  Med Decis Making. 2013;33(5):607-617. doi:10.1177/0272989X12458724PubMedGoogle ScholarCrossref
25.
Dias  S, Sutton  AJ, Welton  NJ, Ades  AE.  Evidence synthesis for decision making 3: heterogeneity—subgroups, meta-regression, bias, and bias-adjustment.  Med Decis Making. 2013;33(5):618-640. doi:10.1177/0272989X13485157PubMedGoogle ScholarCrossref
26.
Signorovitch  JE, Betts  KA, Yan  YS,  et al.  Comparative efficacy of biological treatments for moderate-to-severe psoriasis: a network meta-analysis adjusting for cross-trial differences in reference arm response.  Br J Dermatol. 2015;172(2):504-512. doi:10.1111/bjd.13437PubMedGoogle ScholarCrossref
27.
DerSimonian  R, Laird  N.  Meta-analysis in clinical trials.  Control Clin Trials. 1986;7(3):177-188. doi:10.1016/0197-2456(86)90046-2PubMedGoogle ScholarCrossref
28.
Sawyer  L, Fotheringham  I, Wright  E, Yasmeen  N, Gibbons  C, Holmen Møller  A.  The comparative efficacy of brodalumab in patients with moderate-to-severe psoriasis: a systematic literature review and network meta-analysis.  J Dermatolog Treat. 2018;29(6):557-568. doi:10.1080/09546634.2018.1427205PubMedGoogle ScholarCrossref
29.
National Institute for Health and Care Excellence (NICE). Ixekizumab for treating moderate to severe plaque psoriasis NICE Technology appraisal guidance. https://www.nice.org.uk/guidance/ta442/resources/ixekizumab-for-treating-moderate-to-severe-plaque-psoriasis-pdf-82604781265093. Published April 26, 2017. Accessed November 25, 2019.
30.
Asahina  A, Nakagawa  H, Etoh  T, Ohtsuki  M; Adalimumab M04-688 Study Group.  Adalimumab in Japanese patients with moderate to severe chronic plaque psoriasis: efficacy and safety results from a Phase II/III randomized controlled study.  J Dermatol. 2010;37(4):299-310. doi:10.1111/j.1346-8138.2009.00748.xPubMedGoogle ScholarCrossref
31.
Bissonnette  R, Tardif  JC, Harel  F, Pressacco  J, Bolduc  C, Guertin  MC.  Effects of the tumor necrosis factor-α antagonist adalimumab on arterial inflammation assessed by positron emission tomography in patients with psoriasis: results of a randomized controlled trial.  Circ Cardiovasc Imaging. 2013;6(1):83-90. doi:10.1161/CIRCIMAGING.112.975730PubMedGoogle ScholarCrossref
32.
Menter  A, Tyring  SK, Gordon  K,  et al.  Adalimumab therapy for moderate to severe psoriasis: A randomized, controlled phase III trial.  J Am Acad Dermatol. 2008;58(1):106-115. doi:10.1016/j.jaad.2007.09.010PubMedGoogle ScholarCrossref
33.
Saurat  JH, Stingl  G, Dubertret  L,  et al; CHAMPION Study Investigators.  Efficacy and safety results from the randomized controlled comparative study of adalimumab vs. methotrexate vs. placebo in patients with psoriasis (CHAMPION).  Br J Dermatol. 2008;158(3):558-566. doi:10.1111/j.1365-2133.2007.08315.xPubMedGoogle ScholarCrossref
34.
Gordon  KB, Langley  RG, Leonardi  C,  et al.  Clinical response to adalimumab treatment in patients with moderate to severe psoriasis: double-blind, randomized controlled trial and open-label extension study.  J Am Acad Dermatol. 2006;55(4):598-606. doi:10.1016/j.jaad.2006.05.027PubMedGoogle ScholarCrossref
35.
Cai  L, Gu  J, Zheng  J,  et al.  Efficacy and safety of adalimumab in Chinese patients with moderate-to-severe plaque psoriasis: results from a phase 3, randomized, placebo-controlled, double-blind study.  J Eur Acad Dermatol Venereol. 2017;31(1):89-95. doi:10.1111/jdv.13746PubMedGoogle ScholarCrossref
36.
Goldminz  AM, Suárez-Fariñas  M, Wang  AC, Dumont  N, Krueger  JG, Gottlieb  AB.  CCL20 and IL22 messenger RNA expression after adalimumab vs methotrexate treatment of psoriasis: a randomized clinical trial.  JAMA Dermatol. 2015;151(8):837-846. doi:10.1001/jamadermatol.2015.0452PubMedGoogle ScholarCrossref
37.
Leonardi  CL, Powers  JL, Matheson  RT,  et al; Etanercept Psoriasis Study Group.  Etanercept as monotherapy in patients with psoriasis.  N Engl J Med. 2003;349(21):2014-2022. doi:10.1056/NEJMoa030409PubMedGoogle ScholarCrossref
38.
Papp  KA, Tyring  S, Lahfa  M,  et al; Etanercept Psoriasis Study Group.  A global phase III randomized controlled trial of etanercept in psoriasis: safety, efficacy, and effect of dose reduction.  Br J Dermatol. 2005;152(6):1304-1312. doi:10.1111/j.1365-2133.2005.06688.xPubMedGoogle ScholarCrossref
39.
van de Kerkhof  PC, Segaert  S, Lahfa  M,  et al.  Once weekly administration of etanercept 50 mg is efficacious and well tolerated in patients with moderate-to-severe plaque psoriasis: a randomized controlled trial with open-label extension.  Br J Dermatol. 2008;159(5):1177-1185. doi:10.1111/j.1365-2133.2008.08771.xPubMedGoogle Scholar
40.
Gottlieb  AB, Matheson  RT, Lowe  N,  et al.  A randomized trial of etanercept as monotherapy for psoriasis.  Arch Dermatol. 2003;139(12):1627-1632. doi:10.1001/archderm.139.12.1627PubMedGoogle ScholarCrossref
41.
Reich  K, Nestle  FO, Papp  K,  et al; EXPRESS study investigators.  Infliximab induction and maintenance therapy for moderate-to-severe psoriasis: a phase III, multicentre, double-blind trial.  Lancet. 2005;366(9494):1367-1374. doi:10.1016/S0140-6736(05)67566-6PubMedGoogle ScholarCrossref
42.
Menter  A, Feldman  SR, Weinstein  GD,  et al.  A randomized comparison of continuous vs. intermittent infliximab maintenance regimens over 1 year in the treatment of moderate-to-severe plaque psoriasis.  J Am Acad Dermatol. 2007;56(1):31.e1-31.e15. doi:10.1016/j.jaad.2006.07.017PubMedGoogle ScholarCrossref
43.
Gottlieb  AB, Evans  R, Li  S,  et al.  Infliximab induction therapy for patients with severe plaque-type psoriasis: a randomized, double-blind, placebo-controlled trial.  J Am Acad Dermatol. 2004;51(4):534-542. doi:10.1016/j.jaad.2004.02.021PubMedGoogle ScholarCrossref
44.
Chaudhari  U, Romano  P, Mulcahy  LD, Dooley  LT, Baker  DG, Gottlieb  AB.  Efficacy and safety of infliximab monotherapy for plaque-type psoriasis: a randomised trial.  Lancet. 2001;357(9271):1842-1847. doi:10.1016/S0140-6736(00)04954-0PubMedGoogle ScholarCrossref
45.
Torii  H, Nakagawa  H; Japanese Infliximab Study investigators.  Infliximab monotherapy in Japanese patients with moderate-to-severe plaque psoriasis and psoriatic arthritis. A randomized, double-blind, placebo-controlled multicenter trial.  J Dermatol Sci. 2010;59(1):40-49. doi:10.1016/j.jdermsci.2010.04.014PubMedGoogle ScholarCrossref
46.
Yang  HZ, Wang  K, Jin  HZ,  et al.  Infliximab monotherapy for Chinese patients with moderate to severe plaque psoriasis: a randomized, double-blind, placebo-controlled multicenter trial.  Chin Med J (Engl). 2012;125(11):1845-1851.PubMedGoogle Scholar
47.
Gordon  K, Blauvelt  A, Langley  R. Ixekizumab for treatment of moderate‐to‐severe plaque psoriasis: 60‐week results from a double‐blind phase 3 induction and randomized withdrawal study (UNCOVER‐1). In 73rd Annual Meeting of the American Academy of Dermatology. 2015;F010.
48.
Griffiths  CE, Reich  K, Lebwohl  M,  et al; UNCOVER-2 and UNCOVER-3 investigators.  Comparison of ixekizumab with etanercept or placebo in moderate-to-severe psoriasis (UNCOVER-2 and UNCOVER-3): results from two phase 3 randomised trials.  Lancet. 2015;386(9993):541-551. doi:10.1016/S0140-6736(15)60125-8PubMedGoogle ScholarCrossref
49.
Reich  K, Pinter  A, Leutz  A,  et al.  A randomized, open-label comparison of ixekizumab vs. methotrexate in patients with moderate-to-severe plaque-type psoriasis naive to systemic therapy: interim analysis of week 12 findings.  Br J Dermatol. 2017;177:61-61.Google Scholar
50.
Langley  RG, Elewski  BE, Lebwohl  M,  et al; ERASURE Study Group; FIXTURE Study Group.  Secukinumab in plaque psoriasis--results of two phase 3 trials.  N Engl J Med. 2014;371(4):326-338. doi:10.1056/NEJMoa1314258PubMedGoogle ScholarCrossref
51.
Blauvelt  A, Prinz  JC, Gottlieb  AB,  et al; FEATURE Study Group.  Secukinumab administration by pre-filled syringe: efficacy, safety and usability results from a randomized controlled trial in psoriasis (FEATURE).  Br J Dermatol. 2015;172(2):484-493. doi:10.1111/bjd.13348PubMedGoogle ScholarCrossref
52.
Paul  C, Lacour  JP, Tedremets  L,  et al; JUNCTURE study group.  Efficacy, safety and usability of secukinumab administration by autoinjector/pen in psoriasis: a randomized, controlled trial (JUNCTURE).  J Eur Acad Dermatol Venereol. 2015;29(6):1082-1090. doi:10.1111/jdv.12751PubMedGoogle ScholarCrossref
53.
Griffiths  CE, Strober  BE, van de Kerkhof  P,  et al; ACCEPT Study Group.  Comparison of ustekinumab and etanercept for moderate-to-severe psoriasis.  N Engl J Med. 2010;362(2):118-128. doi:10.1056/NEJMoa0810652PubMedGoogle ScholarCrossref
54.
Zhu  X, Zheng  M, Song  M,  et al; LOTUS Investigators.  Efficacy and safety of ustekinumab in Chinese patients with moderate to severe plaque-type psoriasis: results from a phase 3 clinical trial (LOTUS).  J Drugs Dermatol. 2013;12(2):166-174.PubMedGoogle Scholar
55.
Tsai  TF, Ho  JC, Song  M,  et al; PEARL Investigators.  Efficacy and safety of ustekinumab for the treatment of moderate-to-severe psoriasis: a phase III, randomized, placebo-controlled trial in Taiwanese and Korean patients (PEARL).  J Dermatol Sci. 2011;63(3):154-163. doi:10.1016/j.jdermsci.2011.05.005PubMedGoogle ScholarCrossref
56.
Leonardi  CL, Kimball  AB, Papp  KA,  et al; PHOENIX 1 study investigators.  Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 76-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 1).  Lancet. 2008;371(9625):1665-1674. doi:10.1016/S0140-6736(08)60725-4PubMedGoogle ScholarCrossref
57.
Papp  KA, Langley  RG, Lebwohl  M,  et al; PHOENIX 2 study investigators.  Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 52-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 2).  Lancet. 2008;371(9625):1675-1684. doi:10.1016/S0140-6736(08)60726-6PubMedGoogle ScholarCrossref
58.
Igarashi  A, Kato  T, Kato  M, Song  M, Nakagawa  H; Japanese Ustekinumab Study Group.  Efficacy and safety of ustekinumab in Japanese patients with moderate-to-severe plaque-type psoriasis: long-term results from a phase 2/3 clinical trial.  J Dermatol. 2012;39(3):242-252. doi:10.1111/j.1346-8138.2011.01347.xPubMedGoogle ScholarCrossref
59.
Gelfand  JM, Shin  DB, Alavi  A,  et al.  A Phase IV, Randomized, double-blind, placebo-controlled crossover study of the effects of ustekinumab on vascular inflammation in psoriasis (the VIP-U Trial).  J Invest Dermatol. 2020;140(1):85-93.e2. doi:10.1016/j.jid.2019.07.679PubMedGoogle ScholarCrossref
60.
Ferris  L, Ott  E, Jiang  G, Hong  H, Baran  W.  Efficacy and safety of guselkumab administered with a novel self-Injection device for the treatment of moderate to severe psoriasis: results from the phase III ORION self-dose study through week 16.  Acta Derm Venereol. 2018;29:P063.Google Scholar
61.
Ohtsuki  M, Kubo  H, Morishima  H, Goto  R, Zheng  R, Nakagawa  H.  Guselkumab, an anti-interleukin-23 monoclonal antibody, for the treatment of moderate to severe plaque-type psoriasis in Japanese patients: Efficacy and safety results from a phase 3, randomized, double-blind, placebo-controlled study.  J Dermatol. 2018;45(9):1053-1062. doi:10.1111/1346-8138.14504PubMedGoogle ScholarCrossref
62.
Nakagawa  H, Niiro  H, Ootaki  K; Japanese brodalumab study group.  Brodalumab, a human anti-interleukin-17-receptor antibody in the treatment of Japanese patients with moderate-to-severe plaque psoriasis: Efficacy and safety results from a phase II randomized controlled study.  J Dermatol Sci. 2016;81(1):44-52. doi:10.1016/j.jdermsci.2015.10.009PubMedGoogle ScholarCrossref
63.
Papp  KA, Leonardi  C, Menter  A,  et al.  Brodalumab, an anti-interleukin-17-receptor antibody for psoriasis.  N Engl J Med. 2012;366(13):1181-1189. doi:10.1056/NEJMoa1109017PubMedGoogle ScholarCrossref
64.
Papp  KA, Reich  K, Paul  C,  et al.  A prospective phase III, randomized, double-blind, placebo-controlled study of brodalumab in patients with moderate-to-severe plaque psoriasis.  Br J Dermatol. 2016;175(2):273-286. doi:10.1111/bjd.14493PubMedGoogle ScholarCrossref
65.
Gottlieb  AB, Blauvelt  A, Thaçi  D,  et al.  Certolizumab pegol for the treatment of chronic plaque psoriasis: Results through 48 weeks from 2 phase 3, multicenter, randomized, double-blinded, placebo-controlled studies (CIMPASI-1 and CIMPASI-2).  J Am Acad Dermatol. 2018;79(2):302-314.e6. doi:10.1016/j.jaad.2018.04.012PubMedGoogle ScholarCrossref
66.
Lebwohl  M, Blauvelt  A, Paul  C,  et al.  Certolizumab pegol for the treatment of chronic plaque psoriasis: Results through 48 weeks of a phase 3, multicenter, randomized, double-blind, etanercept- and placebo-controlled study (CIMPACT).  J Am Acad Dermatol. 2018;79(2):266-276.e5. doi:10.1016/j.jaad.2018.04.013PubMedGoogle ScholarCrossref
67.
Reich  K, Ortonne  JP, Gottlieb  AB,  et al.  Successful treatment of moderate to severe plaque psoriasis with the PEGylated Fab’ certolizumab pegol: results of a phase II randomized, placebo-controlled trial with a re-treatment extension.  Br J Dermatol. 2012;167(1):180-190. doi:10.1111/j.1365-2133.2012.10941.xPubMedGoogle ScholarCrossref
68.
Reich  K, Papp  KA, Blauvelt  A,  et al.  Tildrakizumab versus placebo or etanercept for chronic plaque psoriasis (reSURFACE 1 and reSURFACE 2): results from two randomised controlled, phase 3 trials.  Lancet. 2017;390(10091):276-288. doi:10.1016/S0140-6736(17)31279-5PubMedGoogle ScholarCrossref
69.
Papp  K, Thaçi  D, Reich  K,  et al.  Tildrakizumab (MK-3222), an anti-interleukin-23p19 monoclonal antibody, improves psoriasis in a phase IIb randomized placebo-controlled trial.  Br J Dermatol. 2015;173(4):930-939. doi:10.1111/bjd.13932PubMedGoogle ScholarCrossref
70.
Altmeyer  PJ, Matthes  U, Pawlak  F,  et al.  Antipsoriatic effect of fumaric acid derivatives. Results of a multicenter double-blind study in 100 patients.  J Am Acad Dermatol. 1994;30(6):977-981. doi:10.1016/S0190-9622(94)70121-0PubMedGoogle ScholarCrossref
71.
Papp  K, Reich  K, Leonardi  CL,  et al.  Apremilast, an oral phosphodiesterase 4 (PDE4) inhibitor, in patients with moderate to severe plaque psoriasis: Results of a phase III, randomized, controlled trial (Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis [ESTEEM] 1).  J Am Acad Dermatol. 2015;73(1):37-49. doi:10.1016/j.jaad.2015.03.049PubMedGoogle ScholarCrossref
72.
Paul  C, Cather  J, Gooderham  M,  et al.  Efficacy and safety of apremilast, an oral phosphodiesterase 4 inhibitor, in patients with moderate-to-severe plaque psoriasis over 52 weeks: a phase III, randomized controlled trial (ESTEEM 2).  Br J Dermatol. 2015;173(6):1387-1399. doi:10.1111/bjd.14164PubMedGoogle ScholarCrossref
73.
Papp  K, Cather  JC, Rosoph  L,  et al.  Efficacy of apremilast in the treatment of moderate to severe psoriasis: a randomised controlled trial.  Lancet. 2012;380(9843):738-746. doi:10.1016/S0140-6736(12)60642-4PubMedGoogle ScholarCrossref
74.
Ohtsuki  M, Okubo  Y, Komine  M,  et al.  Apremilast, an oral phosphodiesterase 4 inhibitor, in the treatment of Japanese patients with moderate to severe plaque psoriasis: Efficacy, safety and tolerability results from a phase 2b randomized controlled trial.  J Dermatol. 2017;44(8):873-884. doi:10.1111/1346-8138.13829PubMedGoogle ScholarCrossref
75.
Gisondi  P, Del Giglio  M, Cotena  C, Girolomoni  G.  Combining etanercept and acitretin in the therapy of chronic plaque psoriasis: a 24-week, randomized, controlled, investigator-blinded pilot trial.  Br J Dermatol. 2008;158(6):1345-1349. doi:10.1111/j.1365-2133.2008.08564.xPubMedGoogle ScholarCrossref
76.
Meffert  H, Bräutigam  M, Färber  L, Weidinger  G.  Low-dose (1.25 mg/kg) cyclosporin A: treatment of psoriasis and investigation of the influence on lipid profile.  Acta Derm Venereol. 1997;77(2):137-141.PubMedGoogle Scholar
77.
Barker  J, Hoffmann  M, Wozel  G,  et al.  Efficacy and safety of infliximab vs. methotrexate in patients with moderate-to-severe plaque psoriasis: results of an open-label, active-controlled, randomized trial (RESTORE1).  Br J Dermatol. 2011;165(5):1109-1117. doi:10.1111/j.1365-2133.2011.10615.xPubMedGoogle ScholarCrossref
78.
Heydendael  VM, Spuls  PI, Opmeer  BC,  et al.  Methotrexate versus cyclosporine in moderate-to-severe chronic plaque psoriasis.  N Engl J Med. 2003;349(7):658-665. doi:10.1056/NEJMoa021359PubMedGoogle ScholarCrossref
79.
Fallah Arani  S, Neumann  H, Hop  WC, Thio  HB.  Fumarates vs. methotrexate in moderate to severe chronic plaque psoriasis: a multicentre prospective randomized controlled clinical trial.  Br J Dermatol. 2011;164(4):855-861. doi:10.1111/j.1365-2133.2010.10195.xPubMedGoogle ScholarCrossref
80.
Flytström  I, Stenberg  B, Svensson  A, Bergbrant  IM.  Methotrexate vs. ciclosporin in psoriasis: effectiveness, quality of life and safety. A randomized controlled trial.  Br J Dermatol. 2008;158(1):116-121.PubMedGoogle Scholar
81.
Blauvelt  A, Ferris  LK, Yamauchi  PS,  et al.  Extension of ustekinumab maintenance dosing interval in moderate-to-severe psoriasis: results of a phase IIIb, randomized, double-blinded, active-controlled, multicentre study (PSTELLAR).  Br J Dermatol. 2017;177(6):1552-1561. doi:10.1111/bjd.15722PubMedGoogle ScholarCrossref
82.
Blauvelt  A, Lacour  JP, Fowler  JF  Jr,  et al.  Phase III randomized study of the proposed adalimumab biosimilar GP2017 in psoriasis: impact of multiple switches.  Br J Dermatol. 2018;179(3):623-631. doi:10.1111/bjd.16890PubMedGoogle ScholarCrossref
83.
Suleiman  AA, Khatri  A, Oberoi  RK, Othman  AA.  Exposure-response relationships for the efficacy and safety of risankizumab in Japanese subjects with psoriasis  [oublished online October 31, 2019].  Clin Pharmacokinet. 2019. doi:10.1007/s40262-019-00829-2PubMedGoogle Scholar
84.
US National Library of Medicine. A Study of Ustekinumab to Evaluate a "Subject-tailored" Maintenance Dosing Approach in Subjects With Moderate-to-Severe Plaque Psoriasis (PSTELLAR). ClinicalTrials.gov website. https://clinicaltrials.gov/ct2/show/NCT01550744. Accessed August 2018.
85.
US National Library of Medicine. Study to Demonstrate Equivalent Efficacy and to Compare Safety of Biosimilar Adalimumab (GP2017) and Humira (ADACCESS). ClinicalTrials.gov website. https://clinicaltrials.gov/ct2/show/NCT02016105. Accessed August 2018.
86.
US National Library of Medicine. Efficacy and Safety Study of Apremilast (CC-10004) in Subjects With Moderate-to-Severe Plaque-Type Psoriasis (Core Study). ClinicalTrials.gov website. https://clinicaltrials.gov/ct2/show/NCT00773734. Accessed August 2018.
87.
ClinicalTrials.gov. Study of Efficacy and Safety of Brodalumab Compared With Placebo and Ustekinumab in Moderate to Severe Plaque Psoriasis Subjects (AMAGINE-2). https://clinicaltrials.gov/ct2/show/NCT01708603. Accessed December 9, 2019.
88.
ClinicalTrials.gov. Study of Efficacy and Safety of Brodalumab Compared With Placebo and Ustekinumab in Moderate to Severe Plaque Psoriasis Subjects (AMAGINE-3). https://clinicaltrials.gov/ct2/show/NCT01708629. Accessed December 9, 2019.
89.
ClinicalTrials.gov. Safety and Efficacy of Secukinumab Compared to Etanercept in Subjects With Moderate to Severe, Chronic Plaque-Type Psoriasis (FIXTURE). https://clinicaltrials.gov/ct2/show/NCT01358578. Accessed December 9, 2019.
90.
Clinicaltrials.gov. A 52-Week Multicenter, Randomized, Blinded, Parallel-Group Study Comparing the Efficacy and Safety of Ixekizumab to Ustekinumab in Patients With Moderate-to-Severe Plaque Psoriasis (IXORA-S). https://clinicaltrials.gov/ct2/show/NCT02561806. Accessed December 9, 2019.
91.
Haidich  AB.  Meta-analysis in medical research.  Hippokratia. 2010;14(suppl 1):29-37.PubMedGoogle Scholar
92.
Xu  G, Xia  M, Jiang  C,  et al.  Comparative efficacy and safety of thirteen biologic therapies for patients with moderate or severe psoriasis: a network meta-analysis.  J Pharmacol Sci. 2019;139(4):289-303. doi:10.1016/j.jphs.2018.12.006PubMedGoogle ScholarCrossref
93.
Schmitt  J, Rosumeck  S, Thomaschewski  G, Sporbeck  B, Haufe  E, Nast  A.  Efficacy and safety of systemic treatments for moderate-to-severe psoriasis: meta-analysis of randomized controlled trials.  Br J Dermatol. 2014;170(2):274-303. doi:10.1111/bjd.12663PubMedGoogle ScholarCrossref
94.
Sbidian  E, Chaimani  A, Garcia-Doval  I,  et al.  Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis.  Cochrane Database Syst Rev. 2017;12:CD011535. doi:10.1002/14651858.CD011535.pub2PubMedGoogle Scholar
95.
Sawyer  LM, Malottki  K, Sabry-Grant  C,  et al.  Assessing the relative efficacy of interleukin-17 and interleukin-23 targeted treatments for moderate-to-severe plaque psoriasis: a systematic review and network meta-analysis of PASI response.  PLoS One. 2019;14(8):e0220868. doi:10.1371/journal.pone.0220868PubMedGoogle Scholar
96.
Wade  R, Grosso  A, South  E,  et al.  Brodalumab for the treatment of moderate-to-severe plaque psoriasis: an evidence review group evaluation of a NICE single technology appraisal.  Pharmacoeconomics. 2019;37(2):131-139. doi:10.1007/s40273-018-0698-2PubMedGoogle ScholarCrossref
97.
Cui  L, Chen  R, Subedi  S,  et al.  Efficacy and safety of biologics targeting IL-17 and IL-23 in the treatment of moderate-to-severe plaque psoriasis: a systematic review and meta-analysis of randomized controlled trials.  Int Immunopharmacol. 2018;62:46-58. doi:10.1016/j.intimp.2018.06.020PubMedGoogle ScholarCrossref
98.
Armstrong  AW, Betts  KA, Signorovitch  JE,  et al.  Number needed to treat and costs per responder among biologic treatments for moderate-to-severe psoriasis: a network meta-analysis.  Curr Med Res Opin. 2018;34(7):1325-1333. doi:10.1080/03007995.2018.1457516PubMedGoogle ScholarCrossref
99.
Nast  A, Jacobs  A, Rosumeck  S, Werner  RN.  Efficacy and safety of systemic long-term treatments for moderate-to-severe psoriasis: a systematic review and meta-analysis.  J Invest Dermatol. 2015;135(11):2641-2648. doi:10.1038/jid.2015.206PubMedGoogle ScholarCrossref
100.
Sawyer  LM, Cornic  L, Levin  LA, Gibbons  C, Møller  AH, Jemec  GB.  Long-term efficacy of novel therapies in moderate-to-severe plaque psoriasis: a systematic review and network meta-analysis of PASI response.  J Eur Acad Dermatol Venereol. 2019;33(2):355-366. doi:10.1111/jdv.15277PubMedGoogle ScholarCrossref
101.
Shear  N, Joshi  A, Zhao  J, Betts  K, Sinvhal  R, Gisondi  P. Comparison of safety outcomes for treatments of moderate to severe plaque psoriasis through a network meta-analysis. Presented at: 24th World Congress of Dermatology; June 11, 2019; Milan, Italy.
102.
Warren  R, Joshi  A, Betts  K, Li  J, Zhao  J, Williams  D. Comparison of dermatology quality of life index for novel treatments of moderate-to-severe plaque psoriasis: a network meta-analysis. Presented at: 28th European Academy of Dermatology and Venereology Congress; October 12, 2019; Madrid, Spain.
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_Multimedia_LoginSubscribe_Purchase
Close
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_Multimedia_LoginSubscribe_Purchase
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
Close
With a personal account, you can:
  • Track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
jn-learning_Modal_SaveSearch_NoAccess_Purchase
Close

Lookup An Activity

or

Close

My Saved Searches

You currently have no searches saved.

Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close