Management of Moderate to Severe Plaque Psoriasis (Part I): Clinical Update on Antitumor Necrosis Factor Agents

Psoriasis is an immunologic disorder mediated by T cells and proinflammatory cytokines. Novel biologic therapies, targeted at key pathogenic steps, have been developed and provide efficacy without the potential end-organ toxicity induced by traditional therapies. The biologic therapies currently approved for treatment of psoriasis are classified into 2 categories, as defined by their mechanism of action: inhibition of tumor necrosis factor (TNF) (etanercept, infliximab, adalimumab) and modulation of pathogenic activated T cells (alefacept, efalizumab). This review has been prepared in 2 parts: Part 1 focuses on anti-TNF agents and includes new data that have become available through increased clinical experience and use in eligible patients. Part 2 will present new data on T-cell modulators, new molecules in development, and considerations for optimal therapeutic selection for treatment of patients with psoriasis (Journal of Drugs in Dermatology, March 2009).