Efficacy and Safety of Systemic Treatments for Skin and Joint Manifestations in Patients With Psoriasis

March 2020 | Volume 19 | Issue 3 | Original Article | 306 | Copyright © March 2020

Published online February 3, 2020

William Abramovits , Joel Schlessinger

aDermatology Treatment and Research Center, Dallas, TX bAdvanced Skin Research Center, Omaha, NE

The presence and identification of comorbidities may help guide the choice of treatment.8,9 For example, under some circumstances, it may be appropriate for patients at risk of heart failure to avoid the use of TNFis.73 The presence of IBD may limit the use of IL-17A inhibitors due to their potential to exacerbate that disease; TNFis may be a good choice for patients with IBD because adalimumab and infliximab are approved for use in patients with Crohn disease and ulcerative colitis.73 Caution should be taken when considering the use of TNFis in patients with a history of certain chronic or currently active viral infections, such as hepatitis B, hepatitis C, HIV, and tuberculosis,73 although effective treatments may exist for these infections.


Psoriasis is a systemic disease resulting in a spectrum of possible extracutaneous symptoms, complications, and comorbidities, including PsA. A primary goal of PsA treatment is to improve patient quality of life and well-being by controlling symptoms, reverting or preventing further structural damage in joints, normalizing function, and improving social interaction.8,9 The spectrum of modern biologic agents, each with unique efficacy and safety profiles, provides clinicians and patients with multiple options for treatment of the varied systemic manifestations of psoriatic disease. Consideration of the aspects of disease that have the greatest impact on the patient’s everyday life, together with thoughtful choice of an appropriate treatment balancing efficacy in skin and joints, is likely to offer the most significant improvement in individual patients.


W.A. has served on advisory boards, as a speaker, as a consultant, and as an investigator for AbbVie, Akros, Allergan, Amgen, AnaptysBio, Asana, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Dermavant, Dermira, Eli Lilly, Encore, EPI Health, Galderma, Glenmark, GSK, Innovaderm, Janssen Biotech, Kyowa Hakko Kirin, LEO Pharma, MediMetricks, Novartis, Parexel, PharmaDerm, Pfizer, Premier, Promius, Regeneron, Sanofi, Sun Pharma, UCB, Vanda, Valeant, and Xenoport. J.S. has served on advisory boards and as an investigator for AbbVie, Boehringer Ingelheim, Celgene, Dermira, Merck, Novartis, Pfizer, and Valeant.


The authors thank Victoria Kinsley, PhD, of SciMentum, Inc, and Richard Karpowicz, PhD, of Health Interactions, Inc, both of Nucleus Global, for providing medical writing support/editorial support, which was funded by Novartis Pharmaceuticals Corporation, East Hanover, NJ, in accordance with Good Publication Practice guidelines (http://www.ismpp.org/gpp3).


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