Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
Expert Opin Drug Saf. 2024 Sep;23(9):1115-1126. doi: 10.1080/14740338.2024.2392007. Epub 2024 Aug 17.
Biological medications have significantly improved the prognosis of psoriasis patients. All biological drugs (except infliximab) for psoriasis require subcutaneous (SC) administration. Adverse events of biologic drug treatment include injection site reactions. ISRs are a local phenomenon characterized by swelling, erythema, pruritus, and pain around the injection site.
We conducted a review to analyze the differences between the ISRs of various biologics approved for psoriasis. Specifically, the review focused on anti-TNF-α, anti-IL12/23, anti-IL-17, and anti-IL-23 drugs.
Etanercept and adalimumab have reported ISR rates of 37% and 20%, respectively, with erythema, pruritus, pain, and irritation being the most common. Citrate free (CF) solution and thinner needles have reduced ISR associated with adalimumab. Ustekinumab showed a low risk of ISR. Regarding secukinumab and ixekizumab, pain was found to be the most common ISR. The introduction of CF ixekizumab formulation has shown promise in reducing ISRs associated with ixekizumab. The risk of ISR appears insignificant with bimekizumab, brodalumab, and anti-IL23 drugs, with ISR rates ranging from less than 1% to 7.1%. The choice of biologic agent should consider ISR risk. Education on injection techniques and the use of single-dose autoinjectors/pens can mitigate ISR risk.
生物制剂显著改善了银屑病患者的预后。所有用于银屑病的生物药物（英夫利昔单抗除外）都需要皮下（SC）给药。生物药物治疗的不良反应包括注射部位反应。注射部位反应是一种局部现象，其特征为注射部位周围肿胀、红斑、瘙痒和疼痛。
我们进行了一项综述，以分析已批准用于银屑病的各种生物制剂的注射部位反应差异。具体而言，该综述侧重于抗 TNF-α、抗 IL12/23、抗 IL-17 和抗 IL-23 药物。
依那西普和阿达木单抗的注射部位反应发生率分别为 37%和 20%，最常见的反应为红斑、瘙痒、疼痛和刺激。无枸橼酸盐（CF）溶液和更细的针头减少了与阿达木单抗相关的注射部位反应。乌司奴单抗发生注射部位反应的风险较低。关于司库奇尤单抗和依奇珠单抗，发现疼痛是最常见的注射部位反应。CF 依奇珠单抗制剂的问世有望降低与依奇珠单抗相关的注射部位反应。倍美克单抗、布罗达单抗和抗 IL-23 药物发生注射部位反应的风险似乎不显著，注射部位反应发生率低于 1%至 7.1%。生物制剂的选择应考虑注射部位反应风险。注射技术教育和使用单剂量自动注射器/笔可以降低注射部位反应风险。
