New therapies versus first-generation biologic drugs in psoriasis: a review of adverse events and their management

J. M. Carrascosa, E. Del-Alcazar

Research output: Contribution to journalReview articleResearchpeer-review

6 Citations (Scopus)


© 2018 Informa UK Limited, trading as Taylor & Francis Group. Introduction: Biologic drugs have revolutionized the treatment of moderate to severe psoriasis in recent years because of their high efficacy and low risk of toxicity. However, even within the group of biologic therapies, there are differences related to the different mechanisms of action. Areas covered: We review the main adverse events associated with the biologic agents currently available for the treatment of psoriasis and the new inhibitors targeting the p19 subunit of interleukin (IL) 23 and the IL-17A receptor. This review covers injection site reactions, infections, cardiovascular events, demyelinating disorders, tumours, class effects secondary adverse events, immunogenicity, safety in pregnancy and vaccines efficacy. Expert commentary: More than a decade after the first approval of biologic drugs for use in psoriasis, the good safety profile of these drugs is one of the main justifications and incentives for their long-term use. The emergence of new pharmacological groups has made it possible to avoid some of the class effects of first-generation biologic agents and the new therapies appear to pose less risk of reactivation of latent infections, such as hepatitis B virus and tuberculosis. However, they are associated with new adverse effects related to their mechanism of action, including candidiasis and the risk of exacerbation or onset of inflammatory bowel disease.
Original languageEnglish
Pages (from-to)259-273
JournalExpert Review of Clinical Immunology
Issue number4
Publication statusPublished - 3 Apr 2018


  • Adverse event
  • biologics
  • IL-17 inhibitors
  • IL-23 inhibitors
  • psoriasis
  • safety
  • tumour necrosis factor-inhibitor


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