Biologic Treatment in Elderly Patients With Psoriasis: A Systematic Review

With our aging population, an increasing number of psoriasis patients are classified as elderly. However, psoriasis treatment in older adults can be challenging, given an increased number of comorbid conditions and immunosenescence. Biologic agents present a solution to this treatment dilemma becaus...

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Veröffentlicht in:Journal of Cutaneous Medicine and Surgery 2020-03, Vol.24 (2), p.174-186, Article 1203475419897578
Hauptverfasser: Sandhu, Vijay Kumari, Ighani, Arvin, Fleming, Patrick, Lynde, Charles W.
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creator Sandhu, Vijay Kumari
Ighani, Arvin
Fleming, Patrick
Lynde, Charles W.
description With our aging population, an increasing number of psoriasis patients are classified as elderly. However, psoriasis treatment in older adults can be challenging, given an increased number of comorbid conditions and immunosenescence. Biologic agents present a solution to this treatment dilemma because of their high efficacy and favorable tolerability. The objective of this systematic review was to summarize the findings of clinical trial and real-world studies exploring the safety and efficacy of biologic agents in elderly patients with moderate-to-severe psoriasis. We searched MEDLINE, Embase, the Cochrane Library, and clinical trial databases. Studies analyzing biologics for psoriasis were included if elderly patients were the main population of interest or were a separate subgroup in their analysis. Eighteen articles met inclusion criteria after screening. Across all biologic classes, efficacy for biologics between nonelderly adult patient and elderly patients was similar. Adverse events (AEs) and infections occured at a similar frequency between both groups. However, serious AEs were more common in the elderly. The available literature on the safety and efficacy of biologic agents in elderly patients supports the use of these agents in this population. However, serious AEs and discontinuation due to AEs were more common in older patients. As elderly patients have a higher burden of comorbid conditions and an increased baseline vulnerability for AE, physicians should continue to be prudent in screening before initiating biologics and monitor patients more closely as AEs tend to be more severe.
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However, serious AEs were more common in the elderly. The available literature on the safety and efficacy of biologic agents in elderly patients supports the use of these agents in this population. However, serious AEs and discontinuation due to AEs were more common in older patients. 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subjects Anti-Inflammatory Agents - therapeutic use
Antibodies, Monoclonal - therapeutic use
Biological products
Clinical trials
Comorbidity
Dermatologic Agents - therapeutic use
Dermatology
Humans
Life Sciences & Biomedicine
Older people
Psoriasis
Psoriasis - therapy
Science & Technology
Systematic review
Tumor Necrosis Factor-alpha - antagonists & inhibitors
title Biologic Treatment in Elderly Patients With Psoriasis: A Systematic Review
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