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Br J Dermatol. 2012 Nov;167 Suppl 3:12-20. doi: 10.1111/j.1365-2133.2012.11209.x.

Sequential use of biologics in the treatment of moderate-to-severe plaque psoriasis.

Author information

  • 1Department of Dermatology, Western Infirmary, Glasgow G11 6NT, UK. joyceleman@nhs.net


A number of biologic agents, including the tumour necrosis factor (TNF) antagonists etanercept, adalimumab and infliximab, and the interleukin (IL)-12/IL-23 antagonist ustekinumab, are available for the treatment of moderate-to-severe plaque psoriasis in the U.K. Currently, the selection of the first biologic, and the choice of sequential biologics in the event of efficacy/tolerability concerns, is made using a limited evidence base. The efficacy of biologics, the potential mechanisms of primary and secondary failure and the evidence for sequencing therapy among TNF antagonists and between TNF antagonists and IL-12/IL-23 blockade are reviewed. As psoriasis biologics registers begin to produce long-term safety and efficacy data, therapy decisions in plaque psoriasis may become more objective, and it may be possible to individualize treatment based on clinical or pharmacogenetic information.

© 2012 The Authors. BJD © 2012 British Association of Dermatologists.

[PubMed - indexed for MEDLINE]
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