In recent years, the number of agents for treatment of plaque psoriasis has increased rapidly.
Objective
To compare available and investigational agents for treatment of psoriasis.
Methods
Pivotal clinical trials for infliximab, etanercept, adalimumab, ustekinumab, secukinumab, ixekizumab, brodalumab, guselkumab, tildrakizumab, methotrexate, tofacitinib, and apremilast in plaque psoriasis were identified. Percentages of patients achieving PASI 75, 90, and 100 were extracted.
Results
Seventeen publications, including data from 21 trials, were reviewed. All medications were more efficacious in achieving PASI 75 compared to placebo. Ixekizumab exhibited the greatest difference in PASI 75 and PASI 90, while brodalumab showed the greatest difference in PASI 100.
Limitations
Heterogeneity existed in patient demographics and study design including primary endpoint weeks between trials. Data included were only from the primary endpoint week.
Conclusions
All biologics exhibited greater PASI improvement than placebo, with newer agents more capable of achieving PASI 90 and PASI 100. Head-to-head comparator trials are needed for more accurate comparison.
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