The Treatment of Moderate-to-Severe Psoriasis: Prescreening and Monitoring Psoriatic Patients on Biologics
The development of biologics has dramatically altered the treatment of moderate-to-severe
psoriasis while also introducing new standards of care for therapeutic monitoring. Currently,
the biologics approved by the US Food and Drug Administration are divided into 3
classes: T-cell modulators, tumor necrosis factor- inhibitors, and interleukin-12/23 inhibitors.
Although the US Food and Drug Administration has established recommendations for
pre- and peri-treatment screening evaluations, much of the evidence comes from clinical
trials evaluating the short-term safety and efficacy of each medication, rather than longterm
data, or studies that summarize either the appropriateness or feasibility of screening.
Instead of following a blanket algorithm, providers must understand the evidence as it
relates to each medication to determine which tests are appropriate for any specific patient.
This chapter summarizes the current body of evidence and recommends a practical
approach for monitoring psoriasis patients who are receiving biologic therapies.
Semin Cutan Med Surg 29:28-34 © 2010 Elsevier Inc. All rights reserved.
This article reviews the most recent evidence on the efficacy and safety of the TNF inhibitors in psoriasis, with special attention to preventing and managing immunogenicity.