Switching biologic agent in patients with psoriasis: a systematic review and meta-analysis

Area of Science:

• Dermatology
• Pharmacology
• Systematic Reviews

Background:

• Psoriasis treatment frequently involves biologic therapies.
• Switching between biologic treatments is often necessary.
• Limited investigation exists on intraclass versus interclass biologic switching strategies.

Purpose of the Study:

• To compare the efficacy and safety of intraclass versus interclass biologic switching in psoriasis patients.
• To identify preferred biologic agents for different switching strategies.

Main Methods:

• Systematic review and meta-analysis adhering to PRISMA guidelines.
• Searched PubMed and EMBASE for studies on biologic switching in psoriasis.
• Included 19 publications with 679 patients.

Main Results:

• Intraclass switching (519 patients) showed significantly higher Psoriasis Area and Severity Index (PASI)75 achievement at 12 weeks versus interclass switching (139 patients).
• After 16-52 weeks, PASI75 proportions were comparable between intraclass and interclass switching groups.
• Specific agents like adalimumab, ixekizumab, and risankizumab were noted for intraclass switching, while guselkumab was highlighted for interclass transitions.

Conclusions:

• Intraclass biologic switching demonstrates superior short-term efficacy in psoriasis treatment.
• Both intraclass and interclass switching strategies are effective and safe for long-term psoriasis management.
• Adalimumab, ixekizumab, and risankizumab are preferred for intraclass switching; guselkumab for interclass transitions.