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. 2020 Jul;99(1):53-61.
doi: 10.1016/j.jdermsci.2020.06.003. Epub 2020 Jun 18.

Short-term effectiveness of biologics in patients with moderate-to-severe plaque psoriasis: A systematic review and network meta-analysis

Yayoi Tada  1 , Rei Watanabe  2 , Hisashi Noma  3 , Yasumasa Kanai  4 , Takanobu Nomura  4 , Kenji Kaneko  4
Affiliations
Free article

Short-term effectiveness of biologics in patients with moderate-to-severe plaque psoriasis: A systematic review and network meta-analysis

Yayoi Tada et al. J Dermatol Sci. 2020 Jul.
Free article

Abstract

Background: Complete lesion clearance is important to patients with psoriasis.

Objective: To conduct a network meta-analysis of randomized controlled trials of biologic agents available for psoriasis in Japan, using mixed-treatment comparisons.

Methods: MEDLINE and EMBASE were searched to identify randomized clinical trials (placebo-controlled or head-to-head) of infliximab, adalimumab, ustekinumab, secukinumab, ixekizumab, brodalumab, risankizumab or guselkumab in adult patients with moderate-to-severe plaque psoriasis published in English between 01 January 2000 and 31 August 2019. We assessed the proportion of patients who achieved a 100 %, 90 % and 75 % reduction in their Psoriasis Area and Severity Index (PASI) score (PASI100, PASI90 and PASI75) at 10, 12 or 16 weeks after starting biologic treatment, using contrast-based network meta-analysis methods and risk difference (RD). Probabilities of rank and surface under the cumulative ranking (SUCRA) were also estimated.

Results: Data were pooled from 41 trials in 19,248 patients. All biologics were significantly more effective than placebo for PASI100, PASI90 and PASI75. The RD for PASI100 for brodalumab vs ixekizumab was 0.05 (95 % Confidence intervals [CI] -0.02, 0.11), brodalumab vs risankizumab was 0.04 (95 %CI -0.03, 0.11), and risankizumab vs ixekizumab was -0.01 (95 %CI -0.08, 0.06). The SUCRA for PASI100 and PASI90 achievement was 96.8 % and 86.8 %, respectively, for brodalumab, 82.6 % and 90.3 %, respectively for risankizumab, and 78.3 %, 80.9 %, respectively, for ixekizumab.

Conclusion: Of the biologics assessed, brodalumab, ixekizumab and risankizumab were the greatest rates of PASI90 and PASI100 achievement, and a higher probability of being most effective in the induction phase, compared with the other biologics.

Keywords: Biologics; Network meta-analysis; PASI Achievement; Psoriasis; Short-term.

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Conflict of interest statement

Declaration of Competing Interest Y. Tada reports grants and personal fees from Kyowa Kirin, Taiho Pharmaceutical, Novartis Pharma, Eisai, Eli Lilly Japan, Mitsubishi Tanabe Pharma, Maruho, Torii Pharmaceutical, AbbVie, personal fees from Janssen Pharmaceutical, outside the submitted work. R. Watanabe reports personal fees from Abbvie, Eli Lilly Japan, Jenssen Pharmaceutical, Kyowa Kirin, Maruho, Novartis Pharma, Taiho Pharmaceutical, grants from Jenssen Pharmaceutical, outside the submitted work. H. Noma reports personal fees from Kyowa Kirin, during the conduct of the study; personal fees from Boehringer Ingelheim, outside the submitted work. Y. Kanai, T. Nomura and K. Kaneko are employees of Kyowa Kirin.

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