TNF-α inhibitors biosimilars as first line systemic treatment for moderate-to-severe chronic plaque psoriasis

Introduction: Biologics have revolutionized the therapy of moderate-to-severe plaque psoriasis. Yet, despite their greater efficacy over conventional systemic therapies their high cost has represented a burden for healthcare systems, which limited their use. More recently, the availability of several biosimilars at low cost is changing the place in therapy of biologics for psoriasis.Areas covered: The role of TNF- α inhibitors in the management of plaque psoriasis, their efficacy and safety profile are presented. Phase 3 clinical trials and real-life data from the use of TNF- α inhibitor biosimilars in the treatment of plaque psoriasis are also reviewed in detail. Furthermore, arguments in favor of the use of TNF- α inhibitor biosimilars as a first line therapy in moderate-to-severe plaque psoriasis are discussed.Expert opinion: An increasing amount of clinical trials and real-world data show that biosimilars represent a safe and effective alternative to the originator biologics. In the face of ever-increasing healthcare costs and cost-cutting initiatives, switching to biosimilars and starting naïve patients on the best-value biologic can reduce expenditure for patients and payers while maintaining a high-quality care. Moreover, as the cost of biosimilars is approaching the cost of conventional systemic treatments and no longer represents an economic barrier, TNF-α inhibitors biosimilars may represent a first line systemic treatment for patients with moderate-to-severe psoriasis offering a therapeutic option that is effective and safe in the long term.