Integrating Biologic Agents into Management of Moderate-to-Severe Psoriasis: A Consensus of the Canadian Psoriasis Expert Panel

Guenther, Lyn; Langley, Richard; Shear, Neil H.; Bissonnette, Robert; Ho, Vincent; Lynde, Charles; Murray, Eileen; Papp, Kim; Poulin, Yves; Zip, Catherine

doi:10.1007/s10227-005-0035-1

Cited by 45 publications

(64 citation statements)

References 70 publications

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“…In addition to topical therapy, phototherapy, and the oral systemic agents, there are, at the time of this writing, 5 biologics approved in various countries for the treatment of psoriasis with at least one more pending approval. 7,8 Choosing the best treatment for moderate to severe psoriasis becomes more complex both for patients and clinicians. Biologics targeting TNF-alfa are among the most frequently prescribed systemic treatments for psoriasis in the United States and Canada.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of adalimumab in patients with plaque psoriasis who have shown an unsatisfactory response to etanercept

Bissonnette

Bolduc

Poulin

et al. 2010

Journal of the American Academy of Dermatology

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of adalimumab in patients with plaque psoriasis who have shown an unsatisfactory response to etanercept

Bissonnette

Bolduc

Poulin

et al. 2010

Journal of the American Academy of Dermatology

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“…Recently published statements from a Canadian Expert Panel, an American Academy of Dermatology (AAD) consensus meeting, and an International consensus meeting proposed that biological agents such as alefacept, efalizumab, etanercept, and infliximab be considered alongside conventional systemic therapies as first line in the management of moderate-to-severe psoriasis and considered a new class of treatment differing from other forms of therapy in the treatment algorithm. [12][13][14] These statements positioned biological agents as an important addition to the treatment armamentarium for moderate to severe psoriasis, along with phototherapy and traditional systemic agents.…”

Section: Biological Agents In Psoriasis Managementmentioning

confidence: 98%

Recommendations for incorporating biologicals into management of moderate to severe plaque psoriasis: individualized patient approaches

Langley

Lynde

et al. 2005

J Cutan Med Surg

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Psoriasis is a T-cell mediated skin disease that affects approximately 2% of the population worldwide. Despite the prevalence of the disease and long-standing efforts to develop strategies to treat it, there is a need for safe and effective therapies to treat psoriasis, particularly the more severe forms. Biological agents such as alefacept, efalizumab, etanercept, and infliximab have been recognized as a class of treatment distinct from other forms of therapy in the treatment algorithm of psoriasis. Recent national and international consensus meetings have developed statements that position biological agents as an important addition to the treatment armamentarium for moderate to severe psoriasis, along with phototherapy and traditional systemic agents. There has been consensus that treatment should be individualized to each patient's needs and circumstances. Biological agents offer the hope of safe, effective, long-term management of moderate to severe psoriasis. As new agents receive approval from Health Canada, the available range of therapeutic options for treating this chronic disease will broaden. A Canadian Psoriasis Expert Panel recently convened in February 2005 to analyze, based on a series of clinical case scenarios, the indications, contraindications, and considerations for and against each of the four biological agents, derived from product labelling, where available, and from the efficacy and safety data from phase 3 and earlier clinical trials, as well as post-marketing reports. The Panel has formulated a set of recommendations for incorporating these biological agents into the current treatment paradigm of moderate to severe plaque psoriasis and has identified the preferred biological agents for each patient based on individual needs and circumstances.

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“…As with phototherapy and traditional systemic agents, biologicals may be used as a first-line therapy in the treatment of moderate to severe psoriasis. 10,11 The patientÕs severity of disease and suitability profile for a biological must be assessed to ensure that the patient meets all the criteria for therapy and that there are no contraindications. Efalizumab is appropriate to use in adult patients who:…”

Section: Patient Assessmentmentioning

confidence: 99%

Strategies for optimizing treatment with efalizumab in moderate to severe psoriasis

Papp

Langley

et al. 2005

J Cutan Med Surg

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With the advent of biological therapies for the treatment of plaque psoriasis, guidance on the usage of these new agents has become necessary. One such agent, efalizumab, a humanized recombinant monoclonal IgG(1) antibody developed to target T-cell-mediated inflammation, provides rapid and sustained efficacy for many psoriasis patients. This article explores the pretreatment, initiation, and treatment phases with efalizumab therapy. In the pretreatment phase, physicians need to assess patients' disease state and educate them about the course of efalizumab treatment. Prior to initiation, physicians need to establish stable disease, ensure an adequate transition or washout of any prior psoriasis therapeutics, and obtain baseline platelet counts. After initiating treatment, both physician and patient must participate in disease monitoring. Patients responding favourably may receive continuous treatment. Those who do not respond to the drug or who experience adverse events should be managed appropriately in order to continue therapy or be transitioned onto another agent. A growing body of clinical evidence, as well as experience from clinical investigators, has provided much insight into the management strategies for patients undergoing treatment with efalizumab.

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Integrating Biologic Agents into Management of Moderate-to-Severe Psoriasis: A Consensus of the Canadian Psoriasis Expert Panel

Cited by 45 publications

References 70 publications

Efficacy and safety of adalimumab in patients with plaque psoriasis who have shown an unsatisfactory response to etanercept

Efficacy and safety of adalimumab in patients with plaque psoriasis who have shown an unsatisfactory response to etanercept

Recommendations for incorporating biologicals into management of moderate to severe plaque psoriasis: individualized patient approaches

Strategies for optimizing treatment with efalizumab in moderate to severe psoriasis

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