Over the past two decades, the efficacy of biologics for the treatment of plaque psoriasis and other psoriatic diseases have drastically improved. As these immune-mediating therapies become more and more selective in their mode of action, their safety continues to increase as well. In the video below, Andrew Blauvelt, MD, MBA, discusses how the thought on safety with biologic use has changed over the years.
Dr Blauvelt is the president of the Oregon Medical Research Center in Portland, OR. He has previously served as an investigator on various trials, including several clinical studies on the efficacy of risankizumab, an IL-23Â inhibitor for the treatment of psoriasis.
To read more about the comparative efficacy of risankizumab and the latest results from Dr Blauvelt, visit our Dermatology Advances resource.
Transcript
There was kind of some older thinking that having the drug get out of your system quicker was a good thing because if you were having a side effect related to the drug, you would want a quicker acting drug, and then it would be out of your system then you could recover from the side effect.
There's probably some truth to that for the TNF blockers, which have more broad effect on the immune system. So, for example, if you had an infection with a TNF blocker, you would want to be off the TNF blocker as soon as possible. Since they are shorter acting drugs, you could stop the drug, get it out, and recover fro the infection. Some people would use that to say "well, that's a problem with IL-23 blockers," because if you were to have a problem with a IL-23 blocker, you could not get it out of your system for a long time, so therefore, you might have a more prolonged side effect. But that's not the case for the IL-23 blockers like it was for the TNF blockers. So it's a really important point.
 IL-23 blockers are more associated with a more prolonged effect on psoriasis when the drug is actually out of the body and out of the system, so it's a more profound knockdown of the system. You still see the disease staying clear, but you don't have the drug in the blood stream. So, we just don't see infections as being a problem with IL-23 blockers like we saw in the past with TNF blockers.
So there does not appear to be any consequences from a safety point of view for having a prolonged effect on psoriasis. That's really important. A lot of people just think well if you have a prolonged effect on psoriasis, then you have more potential for problems with the drug being around in your body, and that's just not the case.
