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Is It Possible to Discontinue Tumor Necrosis Factor Antagonists after Psoriasis Remission?

Annals of Dermatology 2019년 31권 5호 p.495 ~ 501
김병수 ( Kim Byung-Soo ) - Pusan National University School of Medicine Department of Dermatology

 ( Maverakis Emanual ) - University of California Davis School of Medicine Department of Dermatology
 ( Raychaudhuri Siba P. ) - Veterans Affairs Medical Center Sacramento Division of Rheumatology and Immunology

Abstract


Tumor necrosis factor (TNF) antagonists are highly effective treatments for psoriasis. These agents provide the opportunity to improve disease activity and achieve clinical remission. Despite its efficacy, long-term use of biologics is associated with high financial costs and possibly life-threatening adverse events. Recently, there has been an increasing interest in discontinuing TNF antagonists in patients with psoriasis who have achieved a positive clinical response. However, there is a paucity of data and clinical guidelines concerning the cessation TNF antagonists in psoriasis treatment. Several factors, including cost, subsequent treatment efficacy, relative risks, and tolerability, should be considered before the decision is made to discontinue TNF antagonists. Well-designed clinical trials are necessary to identify factors that may trigger disease exacerbation after medication discontinuation in order to recognize the potential disadvantages of discontinuing treatment in patients who are previously successfully managed on TNF antagonists.

키워드

Discontinuation; Psoriasis; Remission; Tumor necrosis factor antagonist; Withdrawal
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