Psoriasis Treatment with Biologics

Existing TNF-inhbitors:

• Adalimumab (Abbott)
• Infliximab (Janssen Bitotech and other biosimilars (generics)
• Etanercept (Amgen)
• Certolizumab (UCB)

Il-17 antibodies

• Secukinumab (Cosentyx, Novartis):
  • dosage: injected 300mg at weeks 0, 1, 2, 3, and 4 then 300mg or 150mg every 4 weeks, the doctor decides ! The price is the same for both doses !

    Works in 3 weeks (vs 7 for etanercept)

• Ixekizumab (Eli Lilly) :
  • 89.1% of treated individuals with psoriasis achieve a PASI 75 response ! (compared to 4% for the  placebo group).
  • By week 5, half of the treated individuals have achieved PASI75
  • After week 1, there is already a statistically significant difference between cases and controls
• Brodalumab displays fast results which are comparable to Ixekizumab

Number Needed to Treat (NNT) is more forceful when talking what these new biologics do (compared to PASI):

• NNT is around 1.2 for Brodalumab and Ixekizumab vs 5 for Alefacept.
• This means that  for 12 treated patients, 10 will achieve PASI 75. (Alefacept needed 50 patients to have 10 who achieved PASI75)

Contributors

Dr Christophe Hsu – dermatologist. Geneva, Switzerland

S002 – Leonardi C et al. Systemic Therapies for Dermatologists: a Comprehensive Review and Update. AAD 2015 Annual Meeting, San Francisco CA – United States