July 20, 2020
A network meta-analysis spanning 11 biologic therapies for the treatment of psoriasis found comparable short-term efficacy and tolerability among most agents. Researchers published their findings online in the British Journal of Dermatology.
“Using our methodology, we find most biologics cluster together with respect to short‐term efficacy and tolerability, and we do not identify any single agent as ‘best,’” researchers wrote.
The meta-analysis included data from 62 randomized controlled trials comparing biologic therapies with each other, methotrexate, or placebo. The trials spanned a total 31,899 participants and 11 psoriasis biologics: adalimumab, etanercept, infliximab, certolizumab pegol, ustekinumab, secukinumab, ixekizumab, brodalumab, guselkumab, tildrakizumab, and risankizumab.
At 10 weeks to 16 weeks, all biologics were efficacious compared with methotrexate or placebo, researchers reported.
Adalimumab, brodalumab, certolizumab pegol, guselkumab, risankizumab, secukinumab, tildrakizumab, and ustekinumab were similar, with high short-term efficacy and tolerability, hierarchical cluster analyses showed.
Meanwhile, infliximab and ixekizumab also demonstrated high short-term efficacy but relatively lower tolerability compared with the other biologics. Still, the number of drug withdrawals due to adverse events across the network was low, prompting researchers to advise treating the finding with caution.
“These data,” they concluded, “need to be interpreted in the context of longer-term efficacy, effectiveness data, safety, posology, and drug acquisition costs when making treatment decisions.”
Mahil SK, Ezejimofor MC, Exton LS, et al. Comparing the efficacy and tolerability of biologic therapies in psoriasis: an updated network meta-analysis [published online ahead of print, 2020 Jun 20]. Br J Dermatol. 2020;10.1111/bjd.19325. doi:10.1111/bjd.19325