Severe and acute complications of biologics in psoriasis

Elias Oussedik, Nupur U. Patel, Devin R. Cash, Angela S. Gupta, Steven R. Feldman

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations


Biologic therapies have revolutionized the approach to immune-mediated diseases such as psoriasis. Due to their favorable safety profiles and excellent efficacy, biologic agents are considered the gold standard for moderate-to-severe psoriasis. The aim of this paper is to saliently review the severe and acute complications of the Food and Drug Administration (FDA) approved biologic agents for psoriasis. Reviewed agents include tumor necrosis factor alpha inhibitors (etanercept, infliximab, and adalimumab), interleukin 12/23 inhibitors (ustekinumab), and interleukin 17 (IL-17) inhibitors (secukinumab and ixekizumab). While malignancies, serious infections, and major adverse cardiovascular events have been reported, their association with biologic therapy are not hypothesized as causal. However, IL-17 inhibitors appear to cause exacerbations and new cases of inflammatory bowel disease. While more long-term studies are warranted in understanding the biologic's long-term side effect profile, short-term studies have confirmed that the biologics are some of the safest treatment options for psoriasis. Nevertheless, certain populations yield higher risk to acute complications with the biologics than others-physicians must use their judgement and vigilance when monitoring and treating patients undergoing therapy with biological agents.

Original languageEnglish
Pages (from-to)586-596
Number of pages11
JournalGiornale Italiano di Dermatologia e Venereologia
Issue number6
StatePublished - Dec 2017


  • Adalimumab
  • Etanercept
  • Infliximab
  • Psoriasis
  • Secukinumab
  • Ustekinumab


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