Long term efficacy and safety of etanercept in the treatment of psoriasis and psoriatic arthritis

Dario Kivelevitch, Bobbak Mansouri, Alan Menter, Dario Kivelevitch, Bobbak Mansouri, Alan Menter

Abstract

Psoriasis is a chronic, immune-mediated inflammatory disease affecting both the skin and joints. Approximately 20% of patients suffer a moderate to severe form of skin disease and up to 30% have joint involvement. Standard therapies for psoriasis include topical medications, phototherapy, and both oral systemic and biological therapies whereas therapies for psoriatic arthritis include nonsteroidal anti-inflammatory drugs followed by disease modifying antirheumatic drugs and/or tumor necrosis factor (TNF)-α inhibitors and interleukin-12/23p40 inhibitors. Treatment of both diseases is typically driven by disease severity. In the past decade, major advances in the understanding of the immunopathogenesis of psoriasis and psoriatic arthritis have led to the development of numerous biological therapies, which have revolutionized the treatment for moderate to severe plaque psoriasis and psoriatic arthritis. Anti-TNF-α agents are currently considered as first line biological therapies for the treatment of moderate to severe psoriasis and psoriatic arthritis. Currently approved anti-TNF-α agents include etanercept, adalimumab, and infliximab for psoriasis and psoriatic arthritis as well as golimumab and certolizumab for psoriatic arthritis. In this article, we aim to evaluate the long term safety and efficacy of etanercept in psoriasis and psoriatic arthritis.

Keywords: biological therapy; etanercept; psoriasis; psoriatic arthritis; safety; tumor necrosis factor.

Figures

Figure 1
Figure 1
Plaque psoriasis. Note: Classic examples of psoriasis which is characterized by well demarcated, erythematous plaques with an overlying silvery scale which can affect any area of the skin.
Figure 2
Figure 2
Psoriatic arthritis. Notes: Patients with psoriatic arthritis displaying (A) arthritis mutilans, (B) enthesitis of the right Achilles tendon, (C) a right knee effusion and dactylitis of multiple digits, and (D) dactylitis of the fourth toe.
Figure 3
Figure 3
Etanercept molecule. Note: Used with permission from Amgen Inc. (Thousand Oaks, CA, USA). Abbreviation: TNF, tumor necrosis factor.

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