Duration of Remission of Biologic Agents for Chronic Plaque Psoriasis

Background: The efficacy of biologic agents to treat psoriasis has been established in well-designed clinical trials. The primary endpoint is usually a 75% reduction from the baseline Psoriasis Area and Severity Index, stressing acute control of symptoms. Another important endpoint is remission, or duration of response off therapy, which reduces exposure to immunosuppressive agents and potentially lowers costs. Methods:We searched the literature for randomized controlled clinical trials of remission with biologic agents. Results and Conclusions: Among approved biologic agents, alefacept produced the longest posttreatment clinical benefits in responders (7 to 8.6 months after a 12-week course), followed by infliximab (4.7 months after a 6-week, 3-dose induction period), etanercept (2.8 to 3.5 months after 12 weeks of therapy), and efalizumab (2.8 months after 24 weeks of therapy). Long-term response to infliximab in some patients may be limited by neutralizing antibodies. Additional data on adalimumab are needed.