Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep;85(3):572-581.
doi: 10.1016/j.jaad.2021.02.057. Epub 2021 Feb 22.

Comparative safety and benefit-risk profile of biologics and oral treatment for moderate-to-severe plaque psoriasis: A network meta-analysis of clinical trial data

Neil H Shear  1 , Keith A Betts  2 , Ahmed M Soliman  3 , Avani Joshi  3 , Yan Wang  2 , Jing Zhao  4 , Paolo Gisondi  5 , Ranjeeta Sinvhal  3 , April W Armstrong  6
Affiliations
Free article

Comparative safety and benefit-risk profile of biologics and oral treatment for moderate-to-severe plaque psoriasis: A network meta-analysis of clinical trial data

Neil H Shear et al. J Am Acad Dermatol. 2021 Sep.
Free article

Abstract

Background: The comparative safety and benefit-risk profiles of moderate-to-severe psoriasis treatment have not been well studied.

Objective: To compare the short-term (12-16 weeks) and long-term (48-56 weeks) safety and benefit-risk profiles of moderate-to-severe psoriasis treatments.

Methods: A systematic literature review of phase II-IV randomized controlled trials of moderate-to-severe psoriasis treatments was conducted (cutoff: July 1, 2020). Any adverse events (AEs), any serious AEs, and AEs leading to treatment discontinuation were compared using Bayesian network meta-analyses (NMAs).

Results: Fifty-two and 7, respectively, randomized controlled trials were included in the short- and long-term NMAs, respectively. In the short-term NMA, the rates of any AEs were the lowest for tildrakizumab (posterior median: 46.0%), certolizumab (46.2%), and etanercept (49.1%). The rates of any serious AE were the lowest for certolizumab (0.8%), risankizumab (1.2%), and etanercept (1.6%). The rates of AEs leading to treatment discontinuation were the lowest for risankizumab (0.5%), tildrakizumab (1.0%), and guselkumab (1.5%). In the long-term NMA, risankizumab had the lowest rates of all 3 outcomes (67.5%, 4.4%, and 1.0%, respectively) and the most favorable benefit-risk profile.

Limitations: The results may not be generalizable to real-world populations.

Conclusions: Anti-interleukin 23 agents were associated with low rates of safety events. Risankizumab had the most favorable benefit-risk profile in the long term.

Keywords: network meta-analysis; outcomes; psoriasis; safety; treatment.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest Dr Shear is a paid consultant for AbbVie, Amgen, Lilly, Leo, Bausch Health, Sun Pharma, Janssen, Galderma, Otsuka, UCB, Celgene, Sanofi Genzyme, Novartis, and Pfizer. Drs Joshi, Soliman, and Sinvhal are employees of AbbVie and may own AbbVie stock or stock options. Drs Betts, Wang, and Zhao are employees of Analysis Group, Inc, which received payment from AbbVie Inc for participation in this research. Dr Gisondi has served as a speaker or an advisory board member for AbbVie, Almirall, Amgen, BMS, Celgene, Eli-Lilly, Janssen, Leo-pharma, Merck, MSD, Novartis, Pfizer, Sanofi, Sandoz, and UCB Pharma. Dr Armstrong has served as a research investigator or consultant to Leo, AbbVie, UCB, Janssen, Lilly, Novartis, Ortho Dermatologics, Sun, Dermavant, BMS, Sanofi, Regeneron, Dermira, and Modmed.

Comment in

Publication types