• Emanuel Marques, Zoltán Paluch, Petr Boháč, Ondřej Slanař, Jaromír Běláček, and Jana Hercogová.
• Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Králosvské Vinohrady University Hospital, Prague, Czech Republic.
• Int. J. Clin. Pract. 2021 Dec 1; 75 (12): e14915.

BackgroundAlthough biologic agents (BAs) are very effective, solid data proving they are safer than other therapies in psoriasis are still lacking.MethodsA total of 289 psoriatic patients were followed for 30 months; of which number 118 were treated with topical agents alone, 112 received BAs, and the remaining 59 patients were on non-biologic systemic agents (NBSAs). The rates of adverse events in these groups were recorded and statistically analysed.ResultsPatients treated with BAs had higher rates of adverse events (P = .017), including overall infections (P = .003), respiratory infections (P < .001), renal, urinary (P < .001), musculoskeletal, connective tissue (P < .001, and P = .021) and oral cavity-related (P = .046) disorders. Except for the incidence of infections, all the above adverse events occurred more often in our study than in clinical trials. The occurrence of serious adverse events was P = .066, with the incidence of serious infections being P = .164. Unlike patients on topical therapy and NBSAs, patients treated with BAs were forced to discontinue their therapies (P = .001). The Psoriasis Area Severity Index (PASI) and body surface area (BSA) scores were the lowest among patients on BAs.ConclusionWhile BAs were the most effective therapies, they were associated with higher rates of treatment discontinuation and adverse events in comparison with other forms of therapy.© 2021 John Wiley & Sons Ltd.

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