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Biological therapy for pustular psoriasis: a systematic review
Leyre A Falto-Aizpurua1, Rafael F Martin-Garcia1, Osward Y Carrasquillo1
1Department of Dermatology, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.
International Journal of Dermatology
|October 16, 2019
Summary
Biologic agents show promise for pustular psoriasis management. Infliximab and ustekinumab are effective, but more trials are needed for definitive recommendations on these advanced therapies.
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Background:
- Limited data exists on biologic agent efficacy for pustular psoriasis.
- Anecdotal evidence suggests benefits, necessitating rigorous evaluation.
- Pustular psoriasis requires effective therapeutic strategies.
Purpose of the Study:
- To systematically review the efficacy and safety of biologic agents for pustular psoriasis.
- To update current knowledge on biologic therapies for this condition.
- To identify agents with the most robust evidence base.
Main Methods:
- Systematic review of PubMed-published data from 2012 onwards.
- Inclusion of studies on biologic therapies for pustular psoriasis.
- Analysis of data on Tumor Necrosis Factor-alpha (TNF-α) inhibitors, IL-17 antagonists, and other biologics.
Main Results:
- 43 articles were selected from 209 identified, covering 205 patients on TNF-α inhibitors and 86 on other biologics (ustekinumab, secukinumab, brodalumab, ixekizumab, IL-1 inhibitors).
- Most biologic modalities demonstrated favorable overall response rates.
- No serious adverse events were reported, though inconsistent response measures and study variability were noted.
Conclusions:
- Infliximab and ustekinumab exhibit the strongest evidence for efficacy and safety in treating pustular psoriasis.
- Emerging data supports the use of Interleukin-17 (IL-17) antagonists.
- Further prospective, controlled, and comparative trials are essential for establishing objective treatment guidelines.
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