A study published in Journal of the American Academy of Dermatology aimed to compare the short-term (12-16 weeks) and long-term (48-56 weeks) safety and benefit-risk profiles of moderate to severe plaque psoriasis treatments.
As comparative safety and benefit-risk profiles of plaque psoriasis treatments have not been well studied, the authors conducted a systematic literature review of phase 2 to 4 randomized controlled trials (RCTs) of available psoriasis treatments. Any adverse events (AE) or serious AE (SAE), including those that lead to treatment discontinuation, were compared with Bayesian network meta-analyses (NMAs).
Within the results, 52 and 7 RCTs were included in the short- and long-term NMAs, respectively. For the short term, AEs rates were lowest for tildrakizumab (posterior median: 46.0%), certolizumab (46.2%), and etanercept (49.1%), meanwhile SAE rates were lowest for certolizumab (0.8%), risankizumab (1.2%), and etanercept (1.6%). AEs that led to therapy discontinuation were lowest for risankizumab (0.5%), tildrakizumab (1.0%), and guselkumab (1.5%). In comparison, for the long term, risankizumab had the lowest rates of all three outcomes (67.5%, 4.4%, and 1.0%, respectively) and the most favorable benefit-risk profile. The authors add that these results may not be generalizable to real world populations.
At its conclusion, the study noted anti-IL-23 agents were associated with low rates of safety events, with risankizumab had the most favorable benefit-risk profile in the long term. —Jessica Garlewicz
Reference
Shear NH, Betts KA, Soliman AM, et al. Comparative safety and benefit-risk profile of biologics and oral treatments for moderate-to-severe plaque psoriasis: a network meta-analysis of clinical trial data. J Am Acad Dermatol. Published online February 22, 2021. doi:10.1016/j.jaad.2021.02.057
