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Biological Therapies in Dermatology

Learn about the side effects of biological agents in psoriasis treatment, including injection site reactions, malignancy risk, infection risks, and their impact on autoimmune disorders. Understand the development of antibodies and infusion reactions associated with specific biological therapies. Get insights on contraindications and dose equivalencies when switching between oral and systemic corticosteroids.

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Biological Therapies in Dermatology

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  1. Retinoids used in dermatology

  2. Biological agents used in psoriasis

  3. Side effects of biological therapies • @ Injection site reactions occur with all biologic agents are most commonly seen with etanercept. They are rarely serious. • @ All biological agents carry a small increased risk of malignancy, especially lymphoma • @ There is an increased risk of infection & serious infections with all biological agents, reactivation of latent tuberculosis is well recognized. • @ Anti-TNF biological agents are associated with a new onset demyelinating disorders & exacerbation of pre-existing multiple sclerosis. • @ Some patients develop ANA antibodies while on biological therapies, only rarely does this lead to a drug induced lupus which tends to resolve on stopping the medication. • @ Patients may develop antibodies to the biological agents but this is only clinically relevant for infliximab where antibodies are associated with an increased risk of an infusion reactions & reduced efficacy

  4. Side effects of biological therapies (continue) • 2O% of patients on infliximab develop non serious infusion reactions such as headache, flushing & nauseas; 1%develop serious reactions such as anaphylaxis, hypotension & chest pain • @ Adalimumab can be associated with leucopenia & thrombocytopenia, aleacept with lymphopenia & efalzumab with thrombocytopenia. • ******************* • Absolute contraindications include sensitivity to the drug, pregnancy & active or chronic infection • Relative contraindications include a family or personal history of demyelinating diseases, history of malignancy & concomitant immunosuppressive treatment.. Congestive cardiac failure is a contraindication for infliximab & etanercept.. Thrombocytopenia is a contraindication for treatment with efalizumab & lymphopenia is a contraindication for using alefacept

  5. Commercially available topical steroid preperations

  6. Commercially available topical steroid preperations

  7. If you are obliged to change from oral corticosteroid (e.g. due to vomiting) to systemic corticosteroid; the equivalent doses of commonly used systemic steroids are: • If a patient is taking 8Omg/ day of predinosolone orally , this is equal to 12 mg dexamethasone systemically

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