The status of biologic therapies in the treatment of moderate to severe psoriasis.

摘要: Psoriasis is a chronic inflammatory, immune-mediated, genetic disease predominantly affecting the skin and associated with significant patient morbidity. Conventional topical systemic treatment options are numerous generally effective, varying degrees of success rapidity action. However, recurrence inevitable. Biologic agents that target pathogenic T cells have been shown to be effective in patients moderate severe psoriasis, remittive effects alefacept encouraging small proportion patients. Efalizumab recently was withdrawn from US market after 5 years use because 3 cases progressive multifocal leukoencephalopathy (PML), serious life-threatening infection. The tumor necrosis factor alpha (TNF-alpha) inhibitors etanercept, infliximab, adalimumab demonstrated notable initial maintenance efficacy psoriasis but require monitoring safety concerns, including risk for infections. A new class biologic agents, anti-IL-12 IL-23 antibodies (ustekinumab ABT-874), shows promise psoriasis. as medicine, more evidence required regarding long-term safety. Despite these which revolutionized therapy complete clearances not always obtained relapses occur To maintain better control disease, many physicians choosing combination or adjunctive therapies augment results seen agents. date, there no well-controlled studies demonstrating and/or other therapies. Prospective trials this sort therefore needed understand potential risks benefits such approaches.