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Biologicals-a modern treatment of severe psoriasis

Nikoo Rahimy, Malwin Werner, Soroosh Rahimy, Emilia Spelés, Borivoj Werner


Introduction: Psoriasis is a non-contagious inflammatory skin disease (dermatosis) which may also affect other organ systems like the joints, associated ligaments and adjacent soft tissues, the vascular system and the heart. As one of the newest treatment methods, the biologicals are increasingly used as first line treatment of severe psoriasis. The aim of this research is to evaluate the effectiveness of biologicals in the treatment of severe psoriasis.

Materials and Methods: A scientific search on recent clinical data of psoriasis treatment with biologi­cals was performed at, Pubmed and Medscape. In addition, we participated in a con­tinuing medication education (CME) training on psoriasis treatment.

Results: In two randomized placebo-controlled phase III clinical trials with VOYAGE 1: n=837 and VOYAGE 2: n= 992 (n= number of participants), performed by Janssen-Cilag, the level of effective­ness of Guselkumab was tested on patients with moderate to severe plaque-type psoriasis after 16 and 48 weeks and compared to another biological called Adalimumab. After 16 weeks of drug treat­ment, 851% of the participants with Guselkumab and 65.9% with Adalimumab, showed a positive re­sponse with a decline of the psoriatic plaques. After 48 weeks, 80,5% of Guselkumab users and 55.4% of Adalimumab users showed improvement.

Conclusion: After an analysis of the clinical trials of Guselkumab and comparing its effectiveness to Adalimumab, biologicals in general will probably play a very important role as first line treatment of severe psoriasis. Considering the fact, that there is a wide variety of biologicals available on the market right now, it is important to figure out which specific biological has the best effect on each different patient. It needs to be considered, that for maintaining the positive effects of biologicals, a life-long treatment is obligatory and there are no studies about long-term effects and side effects of biologicals until now.


severe psoriasis; biologicals; plaque-forming disease; guselkumab; adalimumab



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