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Potestio L, Camela E, Cacciapuoti S, Fornaro L, Ruggiero A, Martora F, Battista T, Megna M. Biologics for the Management of Erythrodermic Psoriasis: An Updated Review. Clin Cosmet Investig Dermatol 2023; 16:2045-2059. [PMID: 37560255 PMCID: PMC10408653 DOI: 10.2147/ccid.s407813] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023]
Abstract
Erythrodermic psoriasis (EP) is a severe and rare variant of psoriasis (less than 3% of cases), characterized by generalized scaling and erythema affecting more than 90% of body surface area. Several systemic symptoms can be present in patients with EP such as lymphadenopathy, arthralgia, fever, fatigue, dehydration, serum electrolyte disturbances, and tachycardia making this condition a possible life-threatening disease, particularly if appropriate treatments are not performed. In this scenario, effective and safe therapies are required. Unfortunately, the rarity of EP makes head-to-head Phase III trials challenging, leading to the lack of established guidelines for its management. Globally, conventional systemic drugs such as cyclosporine, methotrexate, and retinoids often have contraindications linked to patients' comorbidities and have not shown a high profile of efficacy and safety. Recently, the development of biologic drugs including anti-tumor necrosis factor-α and anti-interleukin 12-23, 23, and 17 has revealed favorable results for the management of plaque psoriasis, making them also a possible therapeutic option for EP disease. However, their use in EP is still off-label. The aim of our study was to review current literature on the use of biologic drugs for the treatment of EPs in order to offer a wide perspective on their possible application in EP management.
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Affiliation(s)
- Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Elisa Camela
- Dermatology Unit, Istituto Dermopatico dell’Immacolata - IRCCS, Rome, Italy
| | - Sara Cacciapuoti
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luigi Fornaro
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Angelo Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Fabrizio Martora
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Teresa Battista
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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2
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Burek-Michalska A, Turno-Kręcicka A, Grant-Kels JM, Grzybowski A. Biologic therapies for psoriasis and eyes. Clin Dermatol 2023; 41:523-527. [PMID: 37586569 DOI: 10.1016/j.clindermatol.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Psoriasis is a systemic inflammatory disorder, manifested mainly by skin lesions, but the inflammation also may affect the joints and eye. Many comorbidities have been described in association with psoriasis, including metabolic syndrome and coronary plaques. The pathomechanism of psoriasis is multifaceted. Both genetic and immunologic aspects play a role in stimulating inflammation. Genetic susceptibility is conditioned by presence of the human leukocyte antigen-C*06:02 risk allele and the inflammatory reaction secondary to cytokines, such as tumor necrosis factor α, interleukin 17 (IL-17), IL-20, IL-23, and interferon alfa. Besides the conventional therapy of topical steroids and immunosuppressants, biologic therapies are widely used in the treatment of psoriasis, psoriatic arthritis, and coexisting uveitis. In the majority of cases, biologic therapy has a beneficial effect on uveitis, but in some cases, some of these drugs can lead to serious side effects threatening vision.
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Affiliation(s)
| | | | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA; Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland; Institute for Research in Ophthalmology, Poznań, Poland
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3
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Martinez-Moreno A, Ocampo-Candiani J, Garza-Rodriguez V. Psoriasis and Cardiovascular Disease: A Narrative Review. Korean J Fam Med 2021; 42:345-355. [PMID: 32512983 PMCID: PMC8490176 DOI: 10.4082/kjfm.20.0053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/29/2020] [Accepted: 05/07/2020] [Indexed: 12/19/2022] Open
Abstract
Psoriasis is a chronic, autoimmune, and inflammatory disease that affects 2% of the world's population. In recent years, it has been demonstrated that psoriasis confers a 25% increase in relative risk of cardiovascular disease, independent of factors such as hyperlipidemia, smoking, and obesity. The objective of this review was to analyze and describe the association between psoriasis and cardiovascular disease. In this review, we describe the epidemiological association of psoriasis and cardiovascular disease, pathophysiology, mechanisms, and its association with the well-known cardiovascular risk calculators. In addition, we describe diagnostic tools, such as imaging techniques and novel biomarkers, that are useful in the evaluation of atherosclerotic cardiovascular disease. Finally, we present different systemic therapies that are used in patients with psoriasis and their effect on atherosclerotic cardiovascular disease. This article provides an overview of the current literature on psoriasis and cardiovascular risk, which can be useful for primary care physicians in their daily clinical practice.
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Affiliation(s)
- Adrian Martinez-Moreno
- Servicio de Dermatología, Hospital Universitario “Dr. José E. González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Jorge Ocampo-Candiani
- Servicio de Dermatología, Hospital Universitario “Dr. José E. González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Veronica Garza-Rodriguez
- Servicio de Dermatología, Hospital Universitario “Dr. José E. González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico
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4
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Dinshaw IJ, Ahmad N, Salim N, Leo BF. Nanoemulsions: A Review on the Conceptualization of Treatment for Psoriasis Using a 'Green' Surfactant with Low-Energy Emulsification Method. Pharmaceutics 2021; 13:1024. [PMID: 34371716 PMCID: PMC8309190 DOI: 10.3390/pharmaceutics13071024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/29/2021] [Accepted: 07/01/2021] [Indexed: 12/13/2022] Open
Abstract
Psoriasis is a skin disease that is not lethal and does not spread through bodily contact. However, this seemingly harmless condition can lead to a loss of confidence and social stigmatization due to a persons' flawed appearance. The conventional methods of psoriasis treatment include taking in systemic drugs to inhibit immunoresponses within the body or applying topical drugs onto the surface of the skin to inhibit cell proliferation. Topical methods are favored as they pose lesser side effects compared to the systemic methods. However, the side effects from systemic drugs and low bioavailability of topical drugs are the limitations to the treatment. The use of nanotechnology in this field has enhanced drug loading capacity and reduced dosage size. In this review, biosurfactants were introduced as a 'greener' alternative to their synthetic counterparts. Glycolipid biosurfactants are specifically suited for anti-psoriatic application due to their characteristic skin-enhancing qualities. The selection of a suitable oil phase can also contribute to the anti-psoriatic effect as some oils have skin-healing properties. The review covers the pathogenic pathway of psoriasis, conventional treatments, and prospective ingredients to be used as components in the nanoemulsion formulation. Furthermore, an insight into the state-of-the-art methods used in formulating nanoemulsions and their progression to low-energy methods are also elaborated in detail.
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Affiliation(s)
- Ignatius Julian Dinshaw
- Department of Chemistry, Faculty of Science, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Noraini Ahmad
- Department of Chemistry, Faculty of Science, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Norazlinaliza Salim
- Integrated Chemical Biophysics Research, Faculty of Science, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Bey Fen Leo
- Nanotechnology & Catalysis Research Centre (NANOCAT), Institute of Advanced Studies, University of Malaya, Kuala Lumpur 50603, Malaysia;
- Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
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5
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Liu LF, Chen JS, Gu J, Xu JH, Jin HZ, Pang XW, Wang G, Yu C, Song ZQ, Guo ZP, Li W, Lai W, Cui PG, Chen M, Fang H, Lyu CZ, Li YZ, Sun Q, Xie HF, Liu XM, Gao XH, Shi YL, Zhao NQ, Zhang W, Zheng M. Etanercept biosimilar (recombinant human tumor necrosis factor-α receptor II: IgG Fc fusion protein) and methotrexate combination therapy in Chinese patients with moderate-to-severe plaque psoriasis: a multicentre, randomized, double-blind, placebo-controlled trial. Arch Dermatol Res 2019; 312:437-445. [DOI: 10.1007/s00403-019-02024-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/12/2019] [Accepted: 12/07/2019] [Indexed: 02/08/2023]
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6
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Bellinato F, Girolomoni G, Gisondi P. Relapse of psoriasis in patients who asked to discontinue etanercept after achieving a stable clinical remission. Br J Dermatol 2019; 181:1319-1320. [DOI: 10.1111/bjd.18225] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- F. Bellinato
- Section of Dermatology and Venereology Department of Medicine University of Verona Verona Italy
| | - G. Girolomoni
- Section of Dermatology and Venereology Department of Medicine University of Verona Verona Italy
| | - P. Gisondi
- Section of Dermatology and Venereology Department of Medicine University of Verona Verona Italy
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Barker J, Girolomoni G, Egeberg A, Goncalves J, Pieper B, Kang T. Anti-TNF biosimilars in psoriasis: from scientific evidence to real-world experience. J DERMATOL TREAT 2019; 31:794-800. [PMID: 31094242 DOI: 10.1080/09546634.2019.1610553] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Tumor necrosis factor (TNF) inhibitors account for a large proportion of drugs used to treat psoriasis and are indicated first-line options in certain settings. Several biosimilar drugs based on the anti-TNF agents adalimumab, infliximab, and etanercept are now available for use in patients with psoriasis. The favorable cost differential of biosimilars is expected to improve access to biologic therapy for biologic-naive psoriasis patients, who are often undertreated. Also, substantial cost savings can be made if patients are switched to biosimilars. To date, most clinical testing of anti-TNF biosimilars approved for use in psoriasis has been performed in patients with rheumatoid arthritis, and the results extrapolated to psoriasis. Although this may initially raise concerns for clinicians looking to start their psoriasis patients on biologic treatment with a biosimilar or switch from an original biologic to a biosimilar, the process of extrapolation is tightly regulated and scientifically justified. Furthermore, available real-world evidence of the safety and efficacy of anti-TNF agents in patients with psoriasis complements clinical trial data in patients with rheumatoid arthritis. When equipped with the appropriate knowledge, clinicians should have confidence to use biosimilars for the treatment of psoriasis.
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Affiliation(s)
- Jonathan Barker
- St John's Institute of Dermatology King's College, London, UK
| | | | - Alexander Egeberg
- Department of Dermatology and Allergy, Gentofte Hospital, Copenhagen, Denmark
| | - Joao Goncalves
- Faculty of Pharmacy, iMed - Research Institute for Medicines, University of Lisbon, Lisbon, Portugal
| | | | - Taegyun Kang
- Samsung Bioepis Co., Ltd, Incheon, Republic of Korea
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8
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Clinical experience with the etanercept biosimilar SB4 in psoriatic patients. Int J Clin Pharm 2019; 41:9-12. [DOI: 10.1007/s11096-018-0769-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 12/14/2018] [Indexed: 10/27/2022]
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Koraćević M, Lalić J, Nedeljković S, Koraćević G. REBOUND PHENOMENON – IMPORTANT AND UBIQUITOUS IN PHARMACOTHERAPY. ACTA MEDICA MEDIANAE 2018. [DOI: 10.5633/amm.2018.0420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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10
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Gisondi P, Bianchi L, Calzavara‐Pinton P, Conti A, Chiricozzi A, Fimiani M, Pellegrino M, Giunta A, Prignano F, Tiberio R, Venturini M, Girolomoni G. Etanercept biosimilar
SB
4 in the treatment of chronic plaque psoriasis: data from the Psobiosimilars registry. Br J Dermatol 2018; 180:409-410. [DOI: 10.1111/bjd.17133] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- P. Gisondi
- Department of Medicine Section of Dermatology and Venereology University of Verona Verona Italy
| | - L. Bianchi
- Section of Dermatology University of Rome Tor Vergata Rome Italy
| | | | - A. Conti
- Department of Head and Neck Surgery Section of Dermatology Azienda Ospedaliero Universitaria Policlinico di Modena Modena Italy
| | - A. Chiricozzi
- Section of Dermatology University of Pisa Pisa Italy
| | - M. Fimiani
- Department of Medical Surgical and Neurological Science Section of Dermatology Siena University Hospital Siena Italy
| | - M. Pellegrino
- Department of Medical Surgical and Neurological Science Section of Dermatology Siena University Hospital Siena Italy
| | - A. Giunta
- Section of Dermatology University of Rome Tor Vergata Rome Italy
| | - F. Prignano
- Department of Surgery and Translational Medicine Section of Dermatology University of Florence Florence Italy
| | - R. Tiberio
- Section of Dermatology ‘Maggiore della Carità’ Hospital University of Eastern Piedmont ‘A. Avogadro’ Novara Italy
| | - M. Venturini
- Section of Dermatology University of Brescia Brescia Italy
| | - G. Girolomoni
- Department of Medicine Section of Dermatology and Venereology University of Verona Verona Italy
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11
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Liu Y, Qin G, Meng Z, Du T, Wang X, Tang Y, Cao J. IL-1β, IL-17A and combined phototherapy predicts higher while previous systemic biologic treatment predicts lower treatment response to etanercept in psoriasis patients. Inflammopharmacology 2018; 27:57-66. [PMID: 30242748 DOI: 10.1007/s10787-018-0530-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 09/07/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND This study aimed to explore the correlation of circulating inflammatory cytokines' levels with treatment response to etanercept (ETN) treatment in psoriasis patients. METHODS 97 moderate-to-severe plaque-psoriasis patients were continuously recruited in this prospective cohort study, and all patients received ETN treatment. Serum samples were collected before and at 6 months (M6) after treatment, and nine inflammatory cytokines expressions were detected by enzyme-linked immuno sorbent assay. Psoriasis Area and Severity Index (PASI) score was evaluated at baseline (M0), 1 month (M1), 3 months (M3) and M6 after treatment, and the corresponding PASI 75/90 responses' rates were calculated. RESULTS Tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β, IL-6, IL-12, IL-17A, IL-22, IL-23, and IL-32 levels were reduced, while IL-10 level was elevated at M6 after ETN treatment compared to baseline. PASI 75/90 responses' rates to ETN were 69.1 and 38.1% at M6, respectively. IL-1β and IL-17A levels were elevated in PASI 75-response patients compared to PASI 75 non-response patients, while IL-17A level was also increased in PASI 90-response patients compared to PASI 90 non-response patients. Multivariate logistic regression revealed that IL-1β, IL-17A and combined phototherapy during study predicted higher, while previous systemic biologic treatment predicted lower PASI 75 response to ETN independently. In addition, IL-17A independently predicted higher PASI 90 response to ETN as well. CONCLUSIONS IL-1β, IL-17A, and combined phototherapy predicts higher while previous systemic biologic treatment predicts lower treatment response to ETN independently in psoriasis patients.
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Affiliation(s)
- Yufang Liu
- Department of Dermatology, The People's Hospital of Shiyan, The Affiliated People's Hospital, Hubei University of Medicine, 39 Middle Chaoyang Road, Shiyan, 442000, China
| | - Guifang Qin
- Department of Dermatology, The People's Hospital of Shiyan, The Affiliated People's Hospital, Hubei University of Medicine, 39 Middle Chaoyang Road, Shiyan, 442000, China
| | - Zudong Meng
- Department of Dermatology, The People's Hospital of Shiyan, The Affiliated People's Hospital, Hubei University of Medicine, 39 Middle Chaoyang Road, Shiyan, 442000, China.
| | - Tianping Du
- Department of Neurosurgery, The People's Hospital of Shiyan, The Affiliated People's Hospital, Hubei University of Medicine, Shiyan, China
| | - Xiaolan Wang
- Department of Dermatology, The People's Hospital of Shiyan, The Affiliated People's Hospital, Hubei University of Medicine, 39 Middle Chaoyang Road, Shiyan, 442000, China
| | - Yong Tang
- Department of Rehabilitation, Sinopharm Dong Feng General Hospital, The Affiliated Dong Feng Hospital, Hubei University of Medicine, Shiyan, China
| | - Jingjing Cao
- Department of Dermatology, The People's Hospital of Shiyan, The Affiliated People's Hospital, Hubei University of Medicine, 39 Middle Chaoyang Road, Shiyan, 442000, China
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Sherman S, Hodak E, Pavlovsky L. Can etanercept treatment failure in moderate-to-severe psoriasis be overcome by addition of low-dose methotrexate? A single-center experience. J DERMATOL TREAT 2018; 29:666-670. [PMID: 29466892 DOI: 10.1080/09546634.2018.1441491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Loss of efficacy is a major anticipated shortcoming of utilizing etanercept and other biologic agents for treating moderate-to-severe psoriasis. PURPOSE To investigate the addition of low-dose methotrexate as a means to increase etanercept drug survival. METHODS Eleven patients with severe psoriasis were switched to a combination of etanercept with low-dose methotrexate therapy, after a primary or secondary failure with etanercept treatment as a monotherapy. Time period for cessation of combined treatment and side effects were documented. The effect of previous methotrexate treatment was investigated. RESULTS Six men and five women were included in the study. The patients had moderate-to-severe psoriasis with a mean baseline Psoriasis Area and Severity Index (PASI) of 29 (median 25). Median duration of etanercept monotherapy was 12 months. Median duration of combined treatment was 13 months. Combined treatment was discontinued in three patients due to side effects. Previous failure of methotrexate monotherapy did not alter the duration of the combined treatment. CONCLUSION Addition of low-dose methotrexate may rescue etanercept therapy after failure of etanercept monotherapy in patients with moderate-to-severe psoriasis.
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Affiliation(s)
- Shany Sherman
- a Department of Dermatology , Rabin Medical Center-Beilinson Hospital , Petach Tikva , Israel
| | - Emmilia Hodak
- a Department of Dermatology , Rabin Medical Center-Beilinson Hospital , Petach Tikva , Israel.,b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Lev Pavlovsky
- a Department of Dermatology , Rabin Medical Center-Beilinson Hospital , Petach Tikva , Israel
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Murdaca G, Negrini S, Magnani O, Penza E, Pellecchio M, Gulli R, Mandich P, Puppo F. Update upon efficacy and safety of etanercept for the treatment of spondyloarthritis and juvenile idiopathic arthritis. Mod Rheumatol 2017; 28:417-431. [DOI: 10.1080/14397595.2017.1366006] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Giuseppe Murdaca
- Department of Internal Medicine, Scleroderma Unit, Clinical Immunology Unit, University of Genova and IRCCS-Azienda Ospedaliera Universitaria San Martino, Genova, Italy
| | - Simone Negrini
- Department of Internal Medicine, Scleroderma Unit, Clinical Immunology Unit, University of Genova and IRCCS-Azienda Ospedaliera Universitaria San Martino, Genova, Italy
| | - Ottavia Magnani
- Department of Internal Medicine, Scleroderma Unit, Clinical Immunology Unit, University of Genova and IRCCS-Azienda Ospedaliera Universitaria San Martino, Genova, Italy
| | - Elena Penza
- Department of Internal Medicine, Scleroderma Unit, Clinical Immunology Unit, University of Genova and IRCCS-Azienda Ospedaliera Universitaria San Martino, Genova, Italy
| | - Marco Pellecchio
- Department of Internal Medicine, Scleroderma Unit, Clinical Immunology Unit, University of Genova and IRCCS-Azienda Ospedaliera Universitaria San Martino, Genova, Italy
| | - Rossella Gulli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, Section of Medical Genetics, University of Genova and IRCCS-Azienda Ospedaliera Universitaria San Martino, Genova, Italy
| | - Paola Mandich
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, Section of Medical Genetics, University of Genova and IRCCS-Azienda Ospedaliera Universitaria San Martino, Genova, Italy
| | - Francesco Puppo
- Department of Internal Medicine, Scleroderma Unit, Clinical Immunology Unit, University of Genova and IRCCS-Azienda Ospedaliera Universitaria San Martino, Genova, Italy
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Strand V, Girolomoni G, Schiestl M, Ernst Mayer R, Friccius-Quecke H, McCamish M. The totality-of-the-evidence approach to the development and assessment of GP2015, a proposed etanercept biosimilar. Curr Med Res Opin 2017; 33:993-1003. [PMID: 28133979 DOI: 10.1080/03007995.2017.1288612] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The aim of this review is to describe the inherent variability that is natural to biologics and, using the proposed etanercept biosimilar (GP2015) as an example, provide details on the "totality-of-the-evidence" concept, whereby all physicochemical, biologic, preclinical, and clinical data for a biosimilar and reference medicine are evaluated in an iterative, stepwise manner and shown to be highly similar. METHODS This review was carried out by a search of published articles, reviews, abstracts and patents in PubMed/Medline and Google Scholar up to November 2016. RESULTS Analytical, functional, preclinical, and clinical data provide a comprehensive understanding of both GP2015 and reference etanercept, and demonstrate a high level of similarity between the two products in accordance with regulatory requirements. The totality of the evidence from all analyses and performed trials provides a robust scientific bridge between the biosimilar and clinical experience with the reference medicine, and is used to justify the use of the biosimilar in all indications for which the reference medicine is approved. CONCLUSION Biologic therapies have revolutionized the treatment of immune-mediated inflammatory diseases. The availability of biosimilars has the potential to improve patient access to biologic medicines and stimulate innovation. Physicians may be unfamiliar with the totality-of-the-evidence concept; therefore education and information on this unique approach to developing biosimilars is required to facilitate the use of biosimilars in clinical practice and allow physicians to make informed treatment decisions.
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Affiliation(s)
- Vibeke Strand
- a Division of Immunology/Rheumatology , Stanford University School of Medicine , Palo Alto , California , USA
| | - Giampiero Girolomoni
- b Dermatology and Venereology Section , University of Verona School of Medicine , Verona , Italy
| | - Martin Schiestl
- c Sandoz Biopharmaceuticals, Sandoz International GmbH , Kundl , Austria
| | - Robert Ernst Mayer
- c Sandoz Biopharmaceuticals, Sandoz International GmbH , Kundl , Austria
| | - Hilke Friccius-Quecke
- d Global Biopharmaceutical Development, Sandoz International GmbH , Holzkirchen , Germany
| | - Mark McCamish
- d Global Biopharmaceutical Development, Sandoz International GmbH , Holzkirchen , Germany
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