Biopharmaceutical Switching in Psoriasis Treatment

作者：Miao Zhang, Seokgyeong Hong, Qingyun Wang, Xiaoying Sun, Yaqiong Zhou, Ying Luo, Liu Liu, Jiao Wang, Chunxiao Wang, Naixuan Lin, Juntang Yan, Xin Li · 发表于：JAMA Dermatology · 年份：2025 · DOI：10.1001/jamadermatol.2025.2714 · 被引用次数：11 · 研究领域：Psoriasis: Treatment and Pathogenesis、Spondyloarthritis Studies and Treatments、Dermatology and Skin Diseases

Importance: Patients with psoriasis may require a switch to another therapy due to high treatment costs, primary effectiveness failure, biologic fatigue, or adverse effects associated with the initial biologic treatment; however, the availability of evidence for the effectiveness and safety of interclass biologic switching for the treatment of psoriasis is unknown. Objective: To investigate the effectiveness and safety of psoriasis treatment after the failure of initial biologic therapy, particularly when patients switch to a second biologic. Data Sources: PubMed, Embase, and the Cochrane Library were searched from inception through January 25, 2025. Study Selection: The study included randomized clinical trials (RCTs) of patients with plaque psoriasis aged 18 years or older involving crossover or switching from 1 biologic agent to another initial biologic within the same or different drug class. Data Extraction and Synthesis: Two researchers independently screened the records and abstracted data using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. Data were pooled using random-effects models. Main Outcomes and Measures: The prespecified primary end point was psoriasis area and severity index (PASI) 90. Secondary end points included clinician- and patient-reported outcomes (PROMs) and safety. Clinical effectiveness was evaluated based on the PASI responses (PASI 75, 90, and 100) and the Investigator's and Physician's Global Assessm...