The biologic agents vary considerably in terms of their long-term duration of effect. Using the definitions provided by the National Psoriasis Foundation Medical Board, the objective of this review was to compare all biologic agents with respect to time to relapse and potential for rebound. Overall, alefacept had the longest off-treatment benefit (29.9 weeks in Psoriasis Area and Severity Index [PASI] 75 responders), followed by ustekinumab (22 weeks), infliximab (19.5 weeks), adalimumab (18 weeks), etanercept (12.1 weeks in PASI 50 responders), and, lastly, efalizumab (9.6 weeks). Rebound was reported commonly for efalizumab (14%) and, extremely rarely, for etanercept (0.002%).
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2.
EllisC.N., KruegerG.G., and Alefacept Clinical Study Group. Treatment of chronic plaque psoriasis by selective targeting of memory effector T lymphocytes. N Engl J Med.2001; 345: 248–55.
3.
GordonK.B., LangleyR.G.Remittive effects of intramuscular alefacept in psoriasis. J Drugs Dermatol.2003; 2(6): 624–8.
4.
CareyW., GlazerS., GottliebA.B., LebwohlM., LeonardiC., MenterA.Relapse, rebound, and psoriasis adverse events: an advisory group report. J Am Acad Dermatol.2006; 54: S171–81.
TsaiT.F., LiuM.T., LiaoY.H., LicuD.Clinical effectiveness and safety experience with efalizumab in the treatment of patients with moderate-to-severe plaque psoriasis in Taiwan: results of an open-label, single-arm pilot study. J Eur Acad Dermatol Venereol.2008; 22: 345–52.
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GordonK.B., GottliebA.B., LeonardiC.L., ElewskiB.E., WangA., JahreisA.Clinical response in psoriasis patients discontinued from and then reinitiated on etanercept therapy. J Dermatol Treat.2006; 17: 9–17.
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MooreA., GordonK.B., KangS., GottliebA., FreundlichB., XiaH.A.A randomized, open-label trial of continuous versus interrupted etanercept therapy in the treatment of psoriasis. J Am Acad Dermatol.2007; 56: 598–603.
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GottliebA.B., ChaudhariU., MulcahyL.D., LiS., DooleyL.T., BakerD.G.Infliximab monotherapy provides rapid and sustained benefit for plaque-type psoriasis. J Am Acad Dermatol.2003; 48: 829–35.
10.
GottliebA.B., EvansR., LiS., DooleyL.T., GuzzoC.A., BakerD.Infliximab induction therapy for patients with severe plaque-type psoriasis: a randomized, double -blind, placebo-controlled trial. J Am Acad Dermatol.2004; 51: 534–42.
11.
MenterA., FeldmanS.R., WeinsteinG.D., PappK., EvansR., GuzzoC.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: 31.e1–15.
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ReichK., NestleF.O., PappK., OrtonneJ.P., EvansR., GuzzoC., EXPRESS study investigators. Infliximab induction and maintenance therapy for moderate-to-severe psoriasis: a phase III, multicentre, double-blind trial. Lancet.2005; 366: 1367–74.
13.
KooJ., KheraP.Update on the mechanisms and efficacy of biologic therapies for psoriasis. J Dermatol Sci.2005; 38: 75–87.
14.
GottliebA., FeldmanS., WeinsteinG., MenterA.Infliximab: One-year Phase III results. Poster presented at: American Academy of Dermatology (AAD) 64th Annual Meeting; March, 2006; San Francisco, Calif.
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Emi AikawaN., de CarvalhoJ.F., Artur Almeida SilvaC., BonfáE.Immunogenicity of anti-TNF-alpha agents in autoimmune diseases. Clin Rev Allergy Immunol.2009 Jun 30 [Epub ahead of print].
16.
BlumR., LebwohlM., WongV., GottliebA., LuoA., HoffmanR.Durability of treatment response in patients with moderate to severe psoriasis following withdrawal from or a dose reduction in adalimumab therapy. Poster presented at: American Academy of Dermatology; February 18–22, 2005; New Orleans, La.
17.
MenterA., TyringS.K., GordonK., KimballA.B., LeonardiC.L., LangleyR.G.Adalimumab therapy for moderate to severe psoriasis: a randomized, controlled phase III trial. J Am Acad Dermatol.2008; 58: 106–15.
18.
LeonardiC.L., KimballA.B., PappK.A., YeildingN., GuzzoC., WangY., 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: 1665–74.
