12.10.15

Biologic Treatments In Dermatology Beyond Psoriasis


Bilologics in Dermatology
Here’s a very informative catalogue of the off-label use of biological drugs in Dermatology by Martinez Leborans et al. which was shared with the dermatological community as Poster at EADV Annual Meeting 2015 – Copenhagen, Denmark

The Off-Label Use Of Biological Drugs In Dermatology  - Our Experience In The Last 10 Years

Biologics have a targeted action against very specific molecules involved in the pathogenic mechanisms of the disease.
For instance, psoriasis treatments often target cytokines involved in the pathogenic pathway, such as Tumor-Necrosis Factor (TNF)

In this study from Spain spanning from 2002 to 2014, 45 different biologic drugs were given for off-label indications in 38 patients (25 male, mean age 41.7 years old)

In which indication were the biologics used ? (percentage of total)
-47% = hidradenitis suppurativa (HS; Verneuil’s disease)
-22% = pemphigus vulgaris (PV)
-11% = Pyoderma Gangrenosum
-9% = Atopic dermatitis (AD)
-3% = Behcet’s disease
-2% = Pityriasis Rubra Pilaris (PRP)
-2% = Psoriatic arthritis (PsA)
-2% = Eosinophilic Folliculitis (Ofuji’s disease)
-2% = Bullous Pemphigoid

Which biologics were used ? (percentage of total)
-44% = Infliximab (Remicade)
-24% = Rituximab (Mabtera, Rituxan)
–18% = Adalimumab (Humira)
-9% = Estekinumab (Stelara)
-5% = Etanercept (Enbrel)

What were the response rates ? (percentage of total)
-25% = total response
-37% = partial response
-20% = no response
-18% = loss of efficacy

Was it safe ?
1 patient had a severe adverse event (AE), and only 8 did not respond

Comments
-This study shows that biologics are given for off-label indications
-Although some biologics have shown indications for off-label treatments, there is no specific data shown in this study…it does however show that they are effective.