Clinical advances in biological therapy for generalized pustular psoriasis: a review.
Expert Opin Biol Ther
; 24(1-2): 37-50, 2024.
Article
in En
| MEDLINE
| ID: mdl-38247394
ABSTRACT
INTRODUCTION:
In 2022, U.S. Food and Drug Administration (FDA) approved the first biologics, intravenous spesolimab, for acute flare of generalized pustular psoriasis (GPP). The drug works by blocking IL-36 signaling, the key pathway of GPP. Among the known mutations causing GPP, IL36RN mutations are most common, and the presence of IL36RN mutations had been found to affect the clinical manifestations and treatment response of GPP. AREAS COVERED Literature search was conducted in PubMed, Embase and ClinicalTrials.gov for relevant studies discussing biologic treatment for GPP with special emphasis on larger studies, pediatric group, pregnant women, and the influence of IL36RN mutation on the effectiveness of biologics. EXPERT OPINION The approval of spesolimab for GPP flare treatment marks a new era. However, whether spesolimab will be placed as the treatment of choice remains unknown, considering its higher cost, lack of direct comparison with existing biologics, and uncertain effects on co-existing plaque-type psoriasis. However, the demonstration of numerically better efficacy for patients carrying pathogenic IL36RN mutations suggests the role of pharmacogenetics in the choices of GPP treatment. Future randomized studies are warranted to investigate the effectiveness and safety of biologics for GPP in pediatric and pregnant groups.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Psoriasis
/
Biological Products
Type of study:
Clinical_trials
Limits:
Child
/
Female
/
Humans
/
Pregnancy
Language:
En
Journal:
Expert Opin Biol Ther
Journal subject:
BIOLOGIA
/
TERAPEUTICA
Year:
2024
Document type:
Article
Affiliation country:
Taiwan
Country of publication:
United kingdom