Management of moderate to severe plaque psoriasis (part I): clinical update on antitumor necrosis factor agents

Jeffrey M Sobell1, Robert E Kalb, Jeffrey M Weinberg

  • 1Tufts Medical Center, Department of Dermatology, Boston, Massachusetts; SkinCare Physicians, Chestnut Hill, MA 02111, USA. jsobell@tufts-nemc.org

Psoriasis is an immunologic disorder mediated by T cells and proinflammatory cytokines. Novel biologic therapies, targeted at key pathogenic steps, have been developed and provide efficacy without the potential end-organ toxicity induced by traditional therapies. The biologic therapies currently approved for treatment of psoriasis are classified into 2 categories, as defined by their mechanism of action: inhibition of tumor necrosis factor (TNF) (etanercept, infliximab, adalimumab) and modulation of pathogenic activated T cells (alefacept, efalizumab). This review has been prepared in 2 parts: Part 1 focuses on anti-TNF agents and includes new data that have become available through increased clinical experience and use in eligible patients. Part 2 will present new data on T-cell modulators, new molecules in development, and considerations for optimal therapeutic selection for treatment of patients with psoriasis (Journal of Drugs in Dermatology, March 2009).

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