Each week we will aim to bring out a concise email that provides 4-5 key pieces of information addressing a specific issue in clinical therapeutics.
This week: Psoriasis (Part 1)
Judith Atallah, Clinical Pharmacist, Ward MM
- BIOLOGICS in Psoriasis. There is ample evidence of the efficacy of the biologics in treating psoriasis. Biologics are complex proteins manufactured in living cells.
- BIOSIMILARS. As these drugs are now starting to come off patent, copies are being made and those biosimilar copies are made in different cell systems to the originator and will differ slightly as a result of manufacturing differences including post translational changes. So they are BIOSIMILARS and NOT GENERICS.
- Cost is a major consideration and established therapies such as methotrexate and phototherapy continue to play a role in the management of moderate to severe plaque psoriasis.
- The biologic workup for patients is extensive and includes general health & treatment history, psoriasis treatment, vaccination history, bloods, Mantoux screening test, PACE and PEST questionnaires.
- Biologic agents use in the treatment of psoriasis include the anti TNF agents (adalimumab, etanercept, and infliximab), the anti-interleukin 12/23 antibody-ustekinumab, the anti IL-17 antibody secukinumab, the T-cell co stimulator inhibitor- abtacept, the Interleukin-6 inhibitor-tocilizumab and the Janus Kinase inhibitor -tofacitinib.
- Network meta-analyses evaluating etanercept, infliximab, adalimumab, and ustekinumab support the designation of infliximab as the most effective of these biologic agents for psoriasis.
Please consider these issues when preparing or interpreting RMMR reports or education sessions. Contributions of content or suggested topics are welcome and should be sent directly to firstname.lastname@example.org.