Anti-tumor necrosis factor therapies for psoriasis

Anti-tumor necrosis factor (TNF) biologic drugs are among the most important advances recently introduced in the treatment of psoriasis. These drugs have modified the traditional view of psoriasis pathogenesis and have changed the approach to the disease and its management. Etanercept and infliximab are the only TNF inhibitors currently approved for plaque psoriasis. Adalimumab is in Phase III trials for this indication. All these drugs are approved for the treatment of psoriatic arthritis. Other TNF-targeting agents are under investigation for psoriasis and other diseases. This article briefly reviews the current knowledge of TNF blockers in psoriasis, with emphasis on pharmacologic profile, mechanism of action, immunogenicity, efficacy, safety, novel aspects related to clinical use (dose, regimens and long-term management) and European and US prescribing guidelines.