Journal of Dermatological Treatment

peerreview_statement

aims_and_scope_url

publication_history

received

accepted

published

Guangdong Basic and Applied Basic Research Foundation Committee

The Sanming Project of Medicine in Shenzhen

The High Level-Hospital Program, Health Commission of Guangdong Province, China

Chinese Guidelines for the Diagnosis and Treatment of Psoriasis (2018 Complete Edition)

Chin J Dermatol

This study aims to evaluate the clinical efficacy, recurrence rate, and drug retention rate of plaque psoriasis with different severity levels treated with Ixekizumab.
A retrospective, multicenter, real-world study was conducted using the China Cathay database to analyze 354 Chinese patients with mild-to-moderate and severe psoriasis who received ixekizumab therapy. Psoriasis Area and Severity Index (PASI) 75/90/100 response rates, absolute PASI values, 3-year drug retention, and recurrence rates were assessed at 2, 4, 12, 24, and 52 weeks.
The baseline PASI scores for the mild-to-moderate group (PASI <10) and severe group (PASI ≥ 10) were 5.6± 2.6 and 20 ± 11, respectively. Except for a difference in the proportion of male patients, there were no differences between the two groups in terms of age,duration of illness, hypertension, hyperlipidemia, cardiovascular diseases, gout and arthropathy. The mild-moderate group showed superior PASI75/90 responses at most timepoints and consistently higher PASI100 rates (all 
Ixekizumab demonstrates superior efficacy in mild-moderate versus severe psoriasis, suggesting greater benefit with early biologic intervention.

Clinical efficacy, drug retention and recurrence of ixekizumab across psoriasis severities: a multicenter retrospective analysis of 354 patients.

Clinical efficacy, drug retention and recurrence of ixekizumab across psoriasis severities: a multicenter retrospective analysis of 354 patients

JAMA Dermatology

<jats:sec id="ab-doi250038-4"><jats:title>Importance</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec id="ab-doi250038-5"><jats:title>Objective</jats:title><jats:p>To investigate the effectiveness and safety of psoriasis treatment after the failure of initial biologic therapy, particularly when patients switch to a second biologic.</jats:p></jats:sec><jats:sec id="ab-doi250038-6"><jats:title>Data Sources</jats:title><jats:p>PubMed, Embase, and the Cochrane Library were searched from inception through January 25, 2025.</jats:p></jats:sec><jats:sec id="ab-doi250038-7"><jats:title>Study Selection</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec id="ab-doi250038-8"><jats:title>Data Extraction and Synthesis</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec id="ab-doi250038-9"><jats:title>Main Outcomes and Measures</jats:title><jats:p>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 Assessments scores of 0 or 1 and body surface area of 1% or less. PROMs included the dermatology life quality index and psoriasis symptoms and signs diary. Safety concerns included adverse events (AEs), serious AEs, severe AEs, treatment-related AEs, and specific AEs.</jats:p></jats:sec><jats:sec id="ab-doi250038-10"><jats:title>Results</jats:title><jats:p>Twenty-four RCTs involving 12 661 patients with psoriasis and 8 switching categories were analyzed. Significant differences observed in PASI 90 between week 4 and week 0 (odds ratio [OR], 6.53; 95% CI, 2.58-16.51). Substantial disparities were noted across various PASI response metrics, specifically PASI 90 (OR, 28.61; 95% CI, 12.89-63.47), PASI 75 (OR, 11.11; 95% CI, 5.95-20.75), and PASI 100 (OR, 18.76; 95% CI, 8.37-42.01). No difference exists in safety outcomes between the end point and week 0, including in serious AEs (OR, 1.63; 95% CI, 0.72-3.69), severe AEs (OR, 1.40; 95% CI, 0.61-3.26), and treatment-related AEs (OR, 1.79; 95% CI, 0.41-7.88). The highest risk of infection was associated with switching from anti−TNF-α agents to anti−interleukin (IL)-23p19, anti−IL-17A, or anti−IL-12/23p40 agents, with infection rates of 0.62%, 0.54% and 0.39%, respectively.</jats:p></jats:sec><jats:sec id="ab-doi250038-11"><jats:title>Conclusions and Relevance</jats:title><jats:p>This systematic review and meta-analysis found that interclass biologic switching was effective in a significant number of patients. With the introduction of biologics with diverse mechanisms of action, these options may become viable and potentially superior. However, further confirmatory data from larger patient cohorts and longer follow-up periods are required to obtain more conclusive results. Our results highlight the importance of vigilance for infections when switching biologics.</jats:p></jats:sec>

Psoriasis: emerging therapeutic strategies.

Nat Rev Drug Discov

Switching biologics in psoriasis - practical guidance and evidence to support.

Expert Rev Clin Pharmacol

Biologic fatigue in psoriasis.

J Dermatolog Treat

Therapeutic strategies: rotational therapy and combinations.

Clin Exp Dermatol

Formation and clinical effects of anti-drug antibodies against biologics in psoriasis treatment: an analysis of current evidence.

Autoimmun Rev

Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics.

J Am Acad Dermatol

Impact of switching between reference biologics and biosimilars of tumour necrosis factor inhibitors for rheumatoid arthritis: a systematic review and network meta-analysis.

Sci Rep

Consensus-based recommendations for the use of biosimilars to treat rheumatological diseases.

Ann Rheum Dis

Systematic review of efficacy of anti-tumor necrosis factor (TNF) therapy in patients with psoriasis previously treated with a different anti-TNF agent.

Long-term efficacy and safety of ixekizumab: a 5-year analysis of the UNCOVER-3 randomized controlled trial.

Dermatology Life Quality Index (DLQI)–a simple practical measure for routine clinical use.

Measurement properties of a patient-reported outcome measure assessing psoriasis severity: The psoriasis symptoms and signs diary.

Safety and efficacy of bimekizumab through 2 years in patients with moderate-to-severe plaque psoriasis: longer-term results from the BE SURE randomized controlled trial and the open-label extension from the BE BRIGHT trial.

Br J Dermatol

Bimekizumab versus adalimumab in plaque psoriasis.

N Engl J Med

Bimekizumab efficacy and safety in patients with moderate to severe plaque psoriasis: two-year interim results from the open-label extension of the randomized BE RADIANT phase 3b trial.

Efficacy and safety of guselkumab in patients with psoriasis who have an inadequate response to ustekinumab: results of the randomized, double-blind, phase III NAVIGATE trial.

Bimekizumab efficacy and safety in patients with moderate-to-severe plaque psoriasis who switched from adalimumab, ustekinumab or secukinumab: results from phase III/IIIb trials.

Safety of guselkumab in patients with moderate-to-severe psoriasis treated through 100 weeks: a pooled analysis from the randomized VOYAGE 1 and VOYAGE 2 studies.

Consistent safety profile with up to 5 years of continuous treatment with guselkumab: Pooled analyses from the phase 3 VOYAGE 1 and VOYAGE 2 trials of patients with moderate-to-severe psoriasis.

Maintenance of skin clearance with ixekizumab treatment of psoriasis: three-year results from the UNCOVER-3 study.

Ixekizumab sustains high level of efficacy and favourable safety profile over 4 years in patients with moderate psoriasis: results from UNCOVER-3 study.

J Eur Acad Dermatol Venereol

Risankizumab compared with adalimumab in patients with moderate-to-severe plaque psoriasis (IMMvent): a randomised, double-blind, active-comparator-controlled phase 3 trial.

Lancet

Five-year efficacy and safety of tildrakizumab in patients with moderate-to-severe psoriasis who respond at week 28: pooled analyses of two randomized phase III clinical trials (reSURFACE 1 and reSURFACE 2).

Diagnosis and management of common tinea infections.

Am Fam Physician

Management of acute upper respiratory tract infection: the role of early intervention.

Expert Rev Respir Med

Latent tuberculosis: two centuries of confusion.

Am J Respir Crit Care Med

The epidemiology of urinary tract infection.

Nat Rev Urol

The complexity of adverse side-effects to biological agents.

J Crohns Colitis

Efficacy and safety of brodalumab in patients with psoriasis who had inadequate responses to ustekinumab: subgroup analysis of two randomized phase III trials.

Long-term efficacy of guselkumab for the treatment of moderate-to-severe psoriasis: results from the phase 3 VOYAGE 1 trial through two years.

J Drugs Dermatol

Efficacy and safety of switching to ixekizumab in etanercept non-responders: a subanalysis from two phase III randomized clinical trials in moderate-to-severe plaque psoriasis (UNCOVER-2 and -3).

Am J Clin Dermatol

Efficacy and safety of tildrakizumab for plaque psoriasis with continuous dosing, treatment interruption, dose adjustments and switching from etanercept: results from phase III studies.

Comparison of ixekizumab with etanercept or placebo in moderate-to-severe psoriasis: Subgroup analysis of Latin American patients in the phase 3 randomized UNCOVER-3 study.

Actas Dermosifiliogr

Efficacy and safety of ixekizumab for the treatment of moderate-to-severe plaque psoriasis: Results through 108 weeks of a randomized, controlled phase 3 clinical trial (UNCOVER-3).

Continuous treatment with guselkumab maintains clinical responses through 4 years in patients with moderate-to-severe psoriasis: results from VOYAGE 1.

Efficacy of switching to risankizumab compared with continued adalimumab treatment in patients with moderate-to-severe plaque psoriasis.

Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the treatment of patients with moderate to severe psoriasis with randomized withdrawal and retreatment: results from the phase III, double-blind, placebo- and active comparator-controlled VOYAGE 2 trial.

Comparison of ustekinumab and etanercept for moderate-to-severe psoriasis.

Maintenance of response through up to 4 years of continuous guselkumab treatment of psoriasis in the VOYAGE 2 phase 3 study.

Five-year maintenance of clinical response and health-related quality of life improvements in patients with moderate-to-severe psoriasis treated with guselkumab: results from VOYAGE 1 and VOYAGE 2.

Patients with persistent mild psoriasis after treatment with ustekinumab achieved greater improvements in skin clearance and patient-reported outcomes after switching to guselkumab in the phase 3 NAVIGATE Trial.

Acta Derm Venereol

Risk of Candida infection and serious infections in patients with moderate-to-severe psoriasis receiving biologics: a systematic review and meta-analysis of randomized controlled trials.

Int J Clin Pract

Th17 cells in immunity to Candida albicans.

Cell Host Microbe

Psoriasis and treatment: past, present and future aspects.

Does the treatment ladder for systemic therapy in moderate to severe psoriasis only go up? The percentage of patients with severe psoriasis on biologics increases over time.

Biosimilars for the treatment of psoriasis: a systematic review of clinical trials and observational studies.

JAMA Dermatol

A review of switching biologic agents in the treatment of moderate-to-severe plaque psoriasis.

Clin Drug Investig

Differential regulation of IL-17A and IL-17F via STAT5 contributes to psoriatic disease.

J Allergy Clin Immunol

The paradigm of IL-23-independent production of IL-17F and IL-17A and their role in chronic inflammatory diseases.

Front Immunol

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.
To investigate the effectiveness and safety of psoriasis treatment after the failure of initial biologic therapy, particularly when patients switch to a second biologic.
PubMed, Embase, and the Cochrane Library were searched from inception through January 25, 2025.
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.
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.
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 Assessments scores of 0 or 1 and body surface area of 1% or less. PROMs included the dermatology life quality index and psoriasis symptoms and signs diary. Safety concerns included adverse events (AEs), serious AEs, severe AEs, treatment-related AEs, and specific AEs.
Twenty-four RCTs involving 12 661 patients with psoriasis and 8 switching categories were analyzed. Significant differences observed in PASI 90 between week 4 and week 0 (odds ratio [OR], 6.53; 95% CI, 2.58-16.51). Substantial disparities were noted across various PASI response metrics, specifically PASI 90 (OR, 28.61; 95% CI, 12.89-63.47), PASI 75 (OR, 11.11; 95% CI, 5.95-20.75), and PASI 100 (OR, 18.76; 95% CI, 8.37-42.01). No difference exists in safety outcomes between the end point and week 0, including in serious AEs (OR, 1.63; 95% CI, 0.72-3.69), severe AEs (OR, 1.40; 95% CI, 0.61-3.26), and treatment-related AEs (OR, 1.79; 95% CI, 0.41-7.88). The highest risk of infection was associated with switching from anti-TNF-α agents to anti-interleukin (IL)-23p19, anti-IL-17A, or anti-IL-12/23p40 agents, with infection rates of 0.62%, 0.54% and 0.39%, respectively.
This systematic review and meta-analysis found that interclass biologic switching was effective in a significant number of patients. With the introduction of biologics with diverse mechanisms of action, these options may become viable and potentially superior. However, further confirmatory data from larger patient cohorts and longer follow-up periods are required to obtain more conclusive results. Our results highlight the importance of vigilance for infections when switching biologics.

Biopharmaceutical Switching in Psoriasis Treatment: A Systematic Review and Meta-Analysis.

Biopharmaceutical Switching in Psoriasis Treatment

Journal of Investigative Dermatology

publisher

articletitle

journaltitle

articlelink

content_type

copyright

Instituto de Salud Carlos III

National Psoriasis Foundation

HudFonden

National Heart, Lung, and Blood Institute

Early Detection and Progression of Subclinical Atherosclerosis in Psoriasis (EDSAP): protocol for an observational, single-centre, prospective cohort study

BMJ Open

Monocyte-to-high-density lipoprotein ratio is associated with systemic inflammation, insulin resistance, and coronary subclinical atherosclerosis in psoriasis: results from 2 observational cohorts

J Invest Dermatol

Systemic inflammation and cardiovascular comorbidity in psoriasis patients: causes and consequences

Achievement of dual low-density lipoprotein cholesterol and high-sensitivity C-reactive protein targets more frequent with the addition of ezetimibe to simvastatin and associated with better outcomes in IMPROVE-IT

Circulation

Sex and race differences in the relationship between obesity and C-reactive protein

Ethn Dis

High-density lipoprotein and inflammation in cardiovascular disease

Transl Res

Association of inflammatory cytokines with non-alcoholic fatty liver disease

Association of biologic therapy with coronary inflammation in patients with psoriasis as assessed by perivascular fat attenuation index

JAMA Cardiol

C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis

Race, gender, and socioeconomic variations in C-reactive protein using the health and retirement study

J Gerontol B Psychol Sci Soc Sci

Chronic inflammation in the etiology of disease across the life span

Nat Med

Risk of myocardial infarction in patients with psoriasis

JAMA

Association of apremilast with vascular inflammation and cardiometabolic function in patients with psoriasis: the VIP-A Phase 4, open-label, nonrandomized clinical trial

Underperformance of clinical risk scores in identifying imaging-based high cardiovascular risk in psoriasis: results from two observational cohorts

Eur J Prev Cardiol

Subclinical liver disease is associated with subclinical atherosclerosis in psoriasis: results from two observational studies

Psoriasis as a human model of disease to study inflammatory atherogenesis

Am J Physiol Heart Circ Physiol

Inflammation, metaflammation and immunometabolic disorders

Nature

Race and gender differences in C-reactive protein levels

J Am Coll Cardiol

Gender and C-reactive protein: data from the Multiethnic Study of Atherosclerosis (MESA) cohort

Am Heart J

Prevalence of metabolic syndrome in patients with psoriasis: a population-based study in the United Kingdom

Coronary plaque characterization in psoriasis reveals high-risk features that improve after treatment in a prospective observational study

Atherosclerosis

Abdominal visceral adiposity is associated with coronary artery plaque lipid-rich necrotic core partly mediated by bone marrow uptake of 18F-FDG positron emission tomography/computed tomography in psoriasis

Geoepidemiology, gender and autoimmune disease

Association of the complement system with subclinical atherosclerosis in psoriasis: findings from an observational cohort study

Gender differences in autoimmune disease

Front Neuroendocrinol

Low-dose colchicine for secondary prevention of cardiovascular disease

Objective measures of psoriasis severity predict mortality: a prospective population-based cohort study [published correction appears in J Invest Dermatol 2018;138:998]

Risk of incident liver disease in patients with psoriasis, psoriatic arthritis, and rheumatoid arthritis: a population-based study

The relationship between body mass index, waist circumference and psoriatic arthritis in the Turkish population

Postepy Dermatol Alergol

High levels of CRP in morbid obesity: the central role of adipose tissue and lessons for clinical practice before and after bariatric surgery

Surg Obes Relat Dis

Eur Heart J

Residual inflammatory risk: addressing the obverse side of the atherosclerosis prevention coin

How common is residual inflammatory risk?

Circ Res

Anticytokine agents: targeting interleukin signaling pathways for the treatment of atherothrombosis

Targeting residual inflammatory risk: the next frontier for atherosclerosis treatment and prevention

Vascul Pharmacol

Inflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy: a collaborative analysis of three randomised trials

C-reactive protein levels and outcomes after statin therapy

Low-dose methotrexate for the prevention of atherosclerotic events

Antiinflammatory therapy with canakinumab for atherosclerotic disease

Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events

Visceral adiposity in psoriasis is associated with vascular inflammation by 18F-Fluorodeoxyglucose positron-emission tomography/computed tomography beyond cardiometabolic disease risk factors in an observational cohort study

JACC Cardiovasc Imaging

Psoriasis-related visceral adiposity and arterial inflammation: a new adiposity disease entity?

C-reactive protein, inflammation and coronary heart disease

Egypt Heart J

SCIL-STROKE (subcutaneous interleukin-1 receptor antagonist in ischemic stroke): a randomized controlled Phase 2 trial

Stroke

Skin inflammation, systemic inflammation, and cardiovascular disease in psoriasis

The psoriasis area and severity index is an independent risk factor for cardiovascular events: a prospective register study

Efficacy and safety of low-dose colchicine after myocardial infarction

Metabolic syndrome and its factors are associated with noncalcified coronary burden in psoriasis: an observational cohort study

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies

J Clin Epidemiol

Global prevalence of obesity in patients with psoriasis: an analysis in the past two decades

Association of obesity and psoriasis: a ten years systematic review

J Adv Res Med Health Sci

High-sensitivity C-reactive protein is a strong predictor of non-alcoholic fatty liver disease

Hepatogastroenterology

C-reactive protein levels in relation to various features of non-alcoholic fatty liver disease among obese patients

J Hepatol

Psoriasis is associated with a higher cardiovascular disease burden, with systemic inflammation being the root cause of this association. The concept of residual inflammation (RI) was defined in patients with features of high-risk atherosclerosis who had increased inflammatory markers in blood, as characterized by high-sensitivity CRP, despite receiving optimal medical therapy. This study aims to assess RI in patients with psoriasis undergoing biologic therapy, specifically defined as high-sensitivity CRP ≥ 2 mg/l despite achieving a PASI ≤ 2. A prospective observational study was conducted across 3 international cohorts (Spain, United States, and Sweden) comprising 209 patients with psoriasis who achieved a PASI ≤ 2 after stable biologic therapy. RI was observed in 36.3% of patients and was significantly associated with higher body mass index, metabolic dysfunction-associated steatotic liver disease, increased baseline systemic inflammation, and visceral adipose tissue. Female sex was identified as a predictor of RI in the 3 cohorts. The study concludes that RI persists despite optimal skin response and is strongly linked with obesity and fatty liver disease. These conditions are highlighted as critical drivers and treatment targets of inflammation in psoriasis.

Residual Inflammation in Patients with Psoriasis Treated with Biologic Therapy: Findings from 3 Prospective Observational Cohorts.

Residual Inflammation in Patients with Psoriasis Treated with Biologic Therapy: Findings from 3 Prospective Observational Cohorts

<jats:sec id="ab-doi230059-4"><jats:title>Importance</jats:title><jats:p>Biologics used for plaque psoriasis have been reported to be associated with an atopic dermatitis (AD) phenotype, or paradoxical eczema, in some patients. The risk factors for this are unknown.</jats:p></jats:sec><jats:sec id="ab-doi230059-5"><jats:title>Objective</jats:title><jats:p>To explore risk of paradoxical eczema by biologic class and identify factors associated with paradoxical eczema.</jats:p></jats:sec><jats:sec id="ab-doi230059-6"><jats:title>Design, Setting, and Participants</jats:title><jats:p>This prospective cohort study used data from the British Association of Dermatologists Biologics and Immunomodulators Register for adults treated with biologics for plaque psoriasis who were seen at multicenter dermatology clinics in the UK and Ireland. Included participants were registered and had 1 or more follow-up visits between September 2007 and December 2022.</jats:p></jats:sec><jats:sec id="ab-doi230059-7"><jats:title>Exposures</jats:title><jats:p>Duration of exposure to tumor necrosis factor (TNF) inhibitors, interleukin (IL) 17 inhibitors, IL-12/23 inhibitors, or IL-23 inhibitors until paradoxical eczema onset, treatment discontinuation, last follow-up, or death.</jats:p></jats:sec><jats:sec id="ab-doi230059-8"><jats:title>Main Outcomes and Measures</jats:title><jats:p>Incidence rates of paradoxical eczema, paradoxical eczema risk by biologic class, and the association of demographic and clinical variables with risk of paradoxical eczema were assessed using propensity score–weighted Cox proportional hazards regression models.</jats:p></jats:sec><jats:sec id="ab-doi230059-9"><jats:title>Results</jats:title><jats:p>Of 56 553 drug exposures considered, 24 997 from 13 699 participants were included. The 24 997 included exposures (median age, 46 years [IQR, 36-55 years]; 57% male) accrued a total exposure time of 81 441 patient-years. A total of 273 exposures (1%) were associated with paradoxical eczema. The adjusted incidence rates were 1.22 per 100 000 person-years for IL-17 inhibitors, 0.94 per 100 000 person-years for TNF inhibitors, 0.80 per 100 000 person-years for IL-12/23 inhibitors, and 0.56 per 100 000 person-years for IL-23 inhibitors. Compared with TNF inhibitors, IL-23 inhibitors were associated with a lower risk of paradoxical eczema (hazard ratio [HR], 0.39; 95% CI, 0.19-0.81), and there was no association of IL-17 inhibitors (HR, 1.03; 95% CI, 0.74-1.42) or IL-12/23 inhibitors (HR, 0.87; 95% CI, 0.66-1.16) with risk of paradoxical eczema. Increasing age (HR, 1.02 per year; 95% CI, 1.01-1.03) and history of AD (HR, 12.40; 95% CI, 6.97-22.06) or hay fever (HR, 3.78; 95% CI, 1.49-9.53) were associated with higher risk of paradoxical eczema. There was a lower risk in males (HR, 0.60; 95% CI, 0.45-0.78).</jats:p></jats:sec><jats:sec id="ab-doi230059-10"><jats:title>Conclusions and Relevance</jats:title><jats:p>In this study, in biologic-treated patients with psoriasis, paradoxical eczema risk was lowest in patients receiving IL-23 inhibitors. Increasing age, female sex, and history of AD or hay fever were associated with higher risk of paradoxical eczema. The overall incidence of paradoxical eczema was low. Further study is needed to replicate these findings.</jats:p></jats:sec>

Psoriasis: classical vs. paradoxical: the yin-yang of TNF and type I interferon.

Biologic agent–associated cutaneous adverse events: a single center experience.

Clin Med Res

Eczematous eruption during anti-interleukin 17 treatment of psoriasis: an emerging condition.

Disease concomitance in psoriasis.

Mutual antagonism of T cells causing psoriasis and atopic eczema.

Genome-wide comparative analysis of atopic dermatitis and psoriasis gives insight into opposing genetic mechanisms.

Am J Hum Genet

Multi-ancestry genome-wide association study of 21,000 cases and 95,000 controls identifies new risk loci for atopic dermatitis.

Nat Genet

Risk of Paradoxical Eczema in Patients Receiving Biologics for Psoriasis

Biologic in Dermatology Research

Clinical efficacy, drug retention and recurrence of ixekizumab across psoriasis severities: a multicenter retrospective analysis of 354 patients

Biopharmaceutical Switching in Psoriasis Treatment

Residual Inflammation in Patients with Psoriasis Treated with Biologic Therapy: Findings from 3 Prospective Observational Cohorts

Risk of Paradoxical Eczema in Patients Receiving Biologics for Psoriasis

A retrospective claims analysis confirms the cost of most biologic agents for psoriasis is increasing more rapidly than medical inflation

Papers