Interclass Biologic Switching Effective for Patients With Psoriasis
Highest risk for infection associated with switching from anti-TNF-α to anti-IL-23p19, anti-IL-17A, anti-IL-12/23p40
By Elana Gotkine (HealthDay News) | August 11, 2025
WEDNESDAY, Aug. 6, 2025 (HealthDay News) -- For patients with psoriasis, interclass biologic switching is effective, but may be associated with increased infection rates, according to a review published online Aug. 6 in JAMA Dermatology.
Miao Zhang, M.D., from the Shanghai University of Traditional Chinese Medicine, and colleagues examined the effectiveness and safety of psoriasis treatment after the failure of initial biologic therapy, especially when patients switch to a second biologic. Twenty-four randomized clinical trials were analyzed, including 12,661 patients with psoriasis and eight switching categories.
The researchers found that between week 4 and week 0, there were significant differences observed in terms of a 90 percent or greater improvement in the Psoriasis Area and Severity Index (PASI 90). Across various PASI response metrics, specifically PASI 90, PASI 75, and PASI 100, substantial disparities were noted (odds ratios, 28.61, 11.11, and 18.76, respectively). Safety outcomes did not differ between the end point and week 0, including in serious adverse events, severe adverse events, and treatment-related adverse events. Switching from antitumor necrosis factor-α agents to anti-interleukin (IL)-23p19, anti-IL17A, or anti-IL-12/23p40 agents was associated with the highest risk for infection, with rates of 0.62, 0.54, and 0.39 percent, respectively.
"Our results also emphasize the vigilance for infections while switching to different biologics," the authors write.