Psoriasis Drugs Ranked by Safety, Efficacy in New Report

Secukinumab had the lowest drug survival and was associated with more adverse events compared with other biologics despite having a higher rate of responders, according to a recent study.

Currently, there is limited real-life data on newer biologics and biosimilar used to treat moderate-to-severe plaque psoriasis.
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In order to examine the safety and efficacy of various therapies, the researchers assessed 3495 treatment series from the DERMBIO registry. A total of 2161 Danish patients with moderate-to-severe plaque psoriasis treated with biologics between January 1, 2007 and March 31, 2017 were included in the study. Of the 3495, 1332 were prescribed adalimumab, 579 were prescribed etanercept, 333 were prescribed infliximab, 1055 were prescribed ustekinumab, and 196 were prescribed secukinumab. The researchers used Cox regression and Kaplan-Meier survival curves to determined drug survival patterns for biologics and their biosimilars, including Enbrel with Benepali and Remicade with Remsima.

Overall, ustekinumab had the highest drug survival. Secukinumab was found to have the lowest drug survival despite having the highest number of responders compared with other biologics.

The researchers did not observe any significant differences in the risk for discontinuation between originator and biosimilars for infliximab or etanercept. Additionally, they found that higher-than-approved dosages were frequently prescribed for all drugs except for adalimumab and secukinumab.

Compared with other agents, secukinumab had higher rate of adverse events, specifically infections, and increased incidence of cardiovascular events, although this rate was low.

“Ustekinumab was associated with the highest drug survival, and secukinumab with the lowest, albeit that most patients on secukinumab were non-naïve. Switching from originator to biosimilar had no significant impact on drug survival, and the safety profiles were comparable,” the researchers concluded. “Adverse events occurred most frequently with secukinumab. Future studies are warranted to assess the long-term safety of novel biologics for psoriasis.”

—Melissa Weiss

Reference:

Egeberg A, Ottosen MB, Gniadecki R, et al. Safety, efficacy, and drug survival of biologics and biosimilars for moderate-to-severe plaque psoriasis [published online November 1, 2017]. Br J Dermatol. doi:10.1111/bjd.16102.