Biopharmaceutical Switching in Psoriasis Treatment

What is the effectiveness and safety of interclass biopharmaceutical switching in psoriasis treatment?This systematic review and meta-analysis of 24 randomized clinical trials including 12 661 patients found that interclass biopharmaceutical switching demonstrated faster short-term and more stable long-term effectiveness. Switching from anti−tumor necrosis factor (TNF)-α agents to anti−interleukin (IL)-23p19 agents and from anti−IL-12/23p40 agents to anti−IL-23p19 agents led to significantly improved effectiveness; however, switching was associated with an increased risk of infection that was higher when switching from anti−TNF-α agents to anti−IL-23p19, anti−IL-17A, and anti−IL-12/23p40 agents.These findings indicate that clinicians may consider biopharmaceutical switching to reduce costs, enhance effectiveness, and minimize adverse events; however, future studies are needed to determine the long-term safety of biologics that target different pathways in clinical practice.

Corresponding Authors: Xin Li, MD, PhD, Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Rd, Shanghai 200437, China (13661956326@163.com); Juntang Yan, MD, PhD, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, North Third Ring East Rd, Beijing 100029, China (13810833460@163.com).

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