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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA

A Journal on Dermatology and Sexually Transmitted Diseases


Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
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Giornale Italiano di Dermatologia e Venereologia 2017 December;152(6):586-96

DOI: 10.23736/S0392-0488.17.05750-9

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Severe and acute complications of biologics in psoriasis

Elias OUSSEDIK 1, Nupur U. PATEL 1, Devin R. CASH 1, Angela S. GUPTA 1, Steven R. FELDMAN 1, 2, 3

1 Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA; 2 Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA; 3 Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA


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Biologic therapies have revolutionized the approach to immune-mediated diseases such as psoriasis. Due to their favorable safety profiles and excellent efficacy, biologic agents are considered the gold standard for moderate-to-severe psoriasis. The aim of this paper is to saliently review the severe and acute complications of the Food and Drug Administration (FDA) approved biologic agents for psoriasis. Reviewed agents include tumor necrosis factor alpha inhibitors (etanercept, infliximab, and adalimumab), interleukin 12/23 inhibitors (ustekinumab), and interleukin 17 (IL-17) inhibitors (secukinumab and ixekizumab). While malignancies, serious infections, and major adverse cardiovascular events have been reported, their association with biologic therapy are not hypothesized as causal. However, IL-17 inhibitors appear to cause exacerbations and new cases of inflammatory bowel disease. While more long-term studies are warranted in understanding the biologic’s long-term side effect profile, short-term studies have confirmed that the biologics are some of the safest treatment options for psoriasis. Nevertheless, certain populations yield higher risk to acute complications with the biologics than others - physicians must use their judgement and vigilance when monitoring and treating patients undergoing therapy with biological agents.


KEY WORDS: Psoriasis - Etanercept - Infliximab - Adalimumab - Ustekinumab - Secukinumab

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Publication History

Issue published online: October 18, 2017
Article first published online: September 12, 2017
Manuscript accepted: August 31, 2017
Manuscript received: August 3, 2017

Cite this article as

Oussedik E, Patel NU, Cash DR, Gupta AS, Feldman SR. Severe and acute complications of biologics in psoriasis. G Ital Dermatol Venereol 2017;152:586-96. DOI: 10.23736/S0392-0488.17.05750-9

Corresponding author e-mail

sfeldman@wakehealth.edu