An update on drug–drug interactions with biologics for the treatment of moderate-to-severe psoriasis

Abstract

Objective: Moderate-to-severe psoriasis is a chronic skin condition that often requires systemic therapy and biologics are the newest systemic treatment available. A favorable aspect of biologics is that they are thought to have minimal risks for drug–drug interactions compared to oral systemic medications such as cyclosporine and methotrexate. However, this assumption has not been recently or adequately reviewed. We reviewed the literature to identify possible drug–drug interactions with biologics and other medications. Methods: We searched PubMed for published case reports, clinical studies, reviews, and Food and Drug Administration (FDA) labels discussing possible drug–drug interactions with biologics for the treatment of moderate-to-severe psoriasis. Results: There were only a small number of published articles describing drug–drug interactions with biologics. Our review identified two case reports, five clinical studies, and three pharmacokinetics reviews. The majority of articles did not observe clinically relevant drug–drug interactions with biologics. FDA labels do suggest a possible relationship between tumor necrosis factor (TNF)-alpha inhibitors and cytochrome P450 (CYP) activity. Conclusion: The paucity of information regarding drug–drug interactions reaffirms the idea that biologics have limited susceptibility to drug–drug interactions compared to other oral medications. Further studies are needed to adequately assess drug–drug interactions with biologics.

Key words::

• psoriasis
• biologics
• drug interactions
• systemic therapy
• internal therapy
• concomitant medications