Immunogenicity in biologic therapy: implications for dermatology

It is now known that all biologic drugs, even those that are fully human, are immunogenic, that is, they have the ability to induce an immune response in the treated patient. Since the presence of antidrug antibodies may influence the levels and function of the drug in the body, this immune response can alter the efficacy of the biologic treatment and even its safety profile, depending on the mechanism of action (neutralizing or nonneutralizing) and/or an accelerated clearance of the drug. Immunogenicity is a dynamic factor that should be taken into account when prescribing biologic therapy in psoriasis, especially in the case of long-term treatment and when assessing secondary loss of response. An understanding of the immunogenicity of biologic therapies and how this can be managed is useful not only for optimizing the treatment strategy used with each drug, but also for designing predictive models of response and even for tailoring therapy on a case-by-case basis.