Combining biologic and phototherapy treatments for psoriasis: safety, efficacy, and patient acceptability

The efficacy and safety of biologic and phototherapy in treating moderate-to-severe psoriasis is well known. However, some patients may not respond well to biologic agents or phototherapy on their own and may require combination therapy. Skillfully combining a biologic agent and phototherapy may pro...

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Bibliographic Details
Published in:Psoriasis (Auckland, New Zealand) New Zealand), 2016-01, Vol.6, p.105-111
Main Authors: Farahnik, Benjamin, Patel, Viraat, Beroukhim, Kourosh, Zhu, Tian Hao, Abrouk, Michael, Nakamura, Mio, Singh, Rasnik, Lee, Kristina, Bhutani, Tina, Koo, John
Format: Article
Language:English
Subjects:
Arthritis
Care and treatment
Combination chemotherapy
Cytokines
Drug dosages
Light therapy
Medicine
Monoclonal antibodies
Patient satisfaction
Phototherapy
Psoriasis
Review
Safety and security measures
Skin
Studies
Ultraviolet radiation
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Summary:The efficacy and safety of biologic and phototherapy in treating moderate-to-severe psoriasis is well known. However, some patients may not respond well to biologic agents or phototherapy on their own and may require combination therapy. Skillfully combining a biologic agent and phototherapy may provide an additive improvement without much increase in risks. To summarize the current state of evidence for the efficacy and safety of combining biologics with phototherapy in the treatment of moderate-to-severe plaque psoriasis. We conducted an extensive search on Pubmed database for English language literature that evaluated the use of a combination of biologic and phototherapy for the treatment of moderate-to-severe psoriasis through January 2016. The search included the following key-words: psoriasis, etanercept, adalimumab, infliximab, ustekinumab, biologics, phototherapy, and combination therapy. The primary literature included randomized controlled trials, a head-to-head study, open-label controlled and uncontrolled trials, case series, and case reports. Etanercept was used in over half of the reported cases, but other biologic agents used included ustekinumab, adalimumab, and infliximab. The vast majority of phototherapy was narrowband ultraviolet B (NBUVB) radiation. Most cases reported enhanced improvement with combination therapy. Serious adverse events throughout the study duration were reported in
ISSN:2230-326X
2230-326X
DOI:10.2147/ptt.s98952