Anti-TNF biosimilars in psoriasis: from scientific evidence to real-world experience

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.

Epidemiology and Treatment of Patients with Rheumatoid Arthritis, Psoriatic Arthritis and Psoriasis in Germany: A Real-World Evidence Study

“…Real-world data are particularly useful to provide insights into the prevalence and treatment of diseases in heterogeneous patient populations beyond that obtained from randomised controlled trials [15,16]. At present, there are limited reports from real-world studies available for RA [17], PsA [3,18] and PSO [18][19][20][21][22]; in particular, real-world studies are scarce for the German population. This retrospective database study aimed to assess the epidemiology, comorbidities, diagnosis and treatment patterns of RA, PsA and PSO in the German population.…”

Latest Advances for the Treatment of Chronic Plaque Psoriasis with Biologics and Oral Small Molecules

“… 37 In the recent years, different anti-TNF-α biosimilars allowed the dermatologist to prescribe effective biologics at a very competitive cost. 38 , 39 Biosimilars are medications very similar to the originator approved biologic without clinically significative safety, purity, and potency differences and different only in terms of the manufacturing process, excipient and delivery device used. The biosimilars are tested versus originators through double-blind crossover design trials assessing pharmacokinetics, immunogenicity and drug safety.…”

Biosimilars for the treatment of patients with psoriasis: A consensus statement from the Biosimilar Working Group of the International Psoriasis Council

“…[1][2][3] Although considerably more effective than traditional systemic therapies, the high cost of biologic agents has limited their use and contributed to inequalities in the care provided to patients with psoriasis in many countries. 1,4,5 One way in which healthcare systems can maximize the value derived for patients from the money it spends on biologic medicines 6 and widen access to biologic therapies is through the use of biosimilars. 7,8 Biosimilars are drugs that are highly similar, with no clinically meaningful differences, to originator biologic medicines, as proven by high-level clinical studies.…”