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Dermatology and Therapy
Published in: Dermatology and Therapy 6/2021

Open Access 01-12-2021 | Etanercept | Original Research

Short-Term Efficacy of Biologic Therapies in Moderate-to-Severe Plaque Psoriasis: A Systematic Literature Review and an Enhanced Multinomial Network Meta-Analysis

Authors: Kyle Fahrbach, Grammati Sarri, David M. Phillippo, Binod Neupane, Samantha E. Martel, Sandeep Kiri, Kristian Reich

Published in: Dermatology and Therapy | Issue 6/2021

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Abstract

Introduction

Many targeted, systemic therapies have been developed for treatment of moderate-to-severe psoriasis (PsO). A network meta-analysis (NMA) allows for comparison between treatments not directly compared in randomized controlled trials (RCT). This study’s objective was to compare the short-term (10–16 weeks) clinical efficacy according to the Psoriasis Area and Severity Index (PASI) among approved biologic treatments for moderate-to-severe PsO using a novel (enhanced) NMA model.

Methods

A systematic literature review (SLR) of RCTs for patients with moderate-to-severe PsO was conducted. English publications in MEDLINE, Embase, and The Cochrane Library up to March 2019 were searched. An enhanced multinomial Bayesian NMA was performed to simultaneously adjust for baseline risk and utilize the conditional nature of the PASI (50, 75, 90, and 100) levels. The model relaxes typical constraints that all treatments must have the same ranks across PASI levels.

Results

The SLR resulted in 319 relevant publications, of which 72 publications from 73 RCTs reporting 10- to 16-week data for at least one PASI response level (30,314 total patients) were included. Interleukin (IL) inhibitors (risankizumab, ixekizumab, brodalumab, secukinumab, and guselkumab) were the best performing treatments for achieving all PASI levels. Etanercept was outperformed by the other subcutaneous tumor necrosis factor α inhibitors. Application of an enhanced NMA model that allowed treatment rankings to differ by PASI level tested the robustness of results of previous NMAs in PsO.

Conclusion

The results of this model confirmed that IL inhibitors are likely the best short-term treatment choices for improving all PASI levels.
Appendix
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Metadata
Title
Short-Term Efficacy of Biologic Therapies in Moderate-to-Severe Plaque Psoriasis: A Systematic Literature Review and an Enhanced Multinomial Network Meta-Analysis
Authors
Kyle Fahrbach
Grammati Sarri
David M. Phillippo
Binod Neupane
Samantha E. Martel
Sandeep Kiri
Kristian Reich
Publication date
01-12-2021
Publisher
Springer Healthcare
Published in
Dermatology and Therapy / Issue 6/2021
Print ISSN: 2193-8210
Electronic ISSN: 2190-9172
DOI
https://doi.org/10.1007/s13555-021-00602-z

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