Biosimilars for the Treatment of Psoriasis

Psoriasis is a chronic skin disease that causes inflammation and the formation of itchy, scaly patches on the skin. It’s an autoimmune condition that causes the immune system to attack healthy skin cells, leading to a buildup of dead skin cells on the surface of the skin. Psoriasis can occur anywhere on the body, but it’s most commonly found on the knees, elbows, trunk, and scalp. The exact cause of psoriasis is unknown, but it’s thought to be a combination of genetic and environmental factors. And although there is no cure for psoriasis, treatments are available to help manage symptoms.

In addition to biologic options, several biosimilars have been approved for the treatment of psoriasis, including adalimumab, etanercept, infliximab, secukinumab, and ustekinumab. In a systematic review of 14 randomized controlled trials and three cohort studies, published in JAMA Dermatology, it was found that there were no clinically or statistically significant differences in safety and efficacy between biosimilars and originators for the treatment of psoriasis. In addition to safety and efficacy, there are other benefits to using biosimilars including:

1. Cost Savings: Biosimilars are designed to deliver similar therapeutic performance as the originator drug but at reduced costs. This can make treatment more affordable for patients and insurance companies.
2. Increased Access to Treatment: Because of the high costs of biologics, many patients are not treated with these products because of cost and reimbursement issues. Biosimilars can provide a more affordable treatment option, increasing access to treatment for more patients.
3. Comparable safety and efficacy: Short-term data has shown that biosimilars pose no major differences with originators in efficacy and safety, but future studies are needed to examine long-term safety and effectiveness in the clinical setting. 

But just like any other therapy, there are risks involved with the use of biosimilars. Biosimilars can be approved for psoriasis on the basis of evidence extrapolated from results in other conditions, meaning that the evidence for the biosimilar may not be specific to psoriasis, which could pose a risk to patients. Biosimilars may also have a higher risk of immunogenicity compared to originator drugs, so a patient may develop an immune response that could reduce its effectiveness or cause adverse effects. Interchangeability is also something to consider. While interchangeability has been approved for some biosimilars, it is not yet clear whether all biosimilars are interchangeable with their originator drugs.

Overall, while biosimilars for psoriasis treatment have been shown to be safe and effective, there are some risks associated with their use, including extrapolation of evidence, immunogenicity, lack of long-term data, and interchangeability. Patients should discuss the risks and benefits of biosimilars with their healthcare provider before starting treatment.

REFERENCES:
Biosimilars for the Treatment of PsoriasisA Systematic Review of Clinical Trials and Observational Studies. Jama Network website. https://jamanetwork.com/journals/jamadermatology/article-abstract/2805555. Accessed September 12, 2023.

Biosimilar Drugs for Psoriasis: Principles, Present, and Near Future. National Library of Medicine website. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6002312/. Accessed September 12, 2023.

4 Psoriasis Biosimilars Showing No Major Differences with Originators in Efficacy, Safety. HCP Live website. https://www.hcplive.com/view/4-psoriasis-biosimilars-showing-no-major-differences-originators-efficacy-safety. Accessed September 12, 2023.  

How May Biosimilars Affect the Treatment of Psoriasis? Practical Dermatology website. https://practicaldermatology.com/articles/2023-feb/how-may-biosimilars-affect-the-treatment-of-psoriasis. Accessed September 12, 2023.