Injections Site Reactions and Biologics for Psoriasis: A Questionnaire Based Real Life Study

Abstract

Background

Biologic selection for psoriasis treatment should take into account numerous factors including injection site reactions (ISRs) such as swelling at the injection site, pain, burning, erythema, all possibly reducing patient adherence.

Methods

A 6-months observational real life study was performed involving psoriasis patients. Inclusion criteria were age ≥ 18 years, moderate-to-severe psoriasis diagnosis since at least 1 year, patients being on biologic treatment for psoriasis ≥ 6 months. A 14-item questionnaire was administered to all patients enrolled to assess whether the patient ever experienced ISRs after the injection of the biologic drug.

Results

234 patients were included: 32.5% received an anti-TNF-alpha drug, 9.4% received anti-IL12/23, 32.5% received an anti-IL17, 25.6% received an anti-IL23. 51.2% of study population reported at least one symptom related to ISR. 35.9% of patients experienced pain, 31.6% swelling, 28.2% burning sensation and 17.9% erythema. 3.4% of the surveyed population experienced anxiety or fear of the biologic injection due to ISRs symptoms. The greater incidence of pain was registered in anti-TNF-alpha and anti-IL17 groups (47.4% and 42.1%, p<0.01). Ixekizumab proved to be the drug with the highest rate of patients experiencing pain (72.2%), burning (77.7%) and swelling (83.3%). No patients reported biologics discontinuation or delay for ISRs symptoms.

Conclusion

Our study highlighted that each different class of biologics for psoriasis was linked to ISRs. These events are more frequently reported with anti-TNF-alpha and anti-IL17.

Keywords:

• psoriasis
• injection site reactions
• biologic therapy

Data Sharing Statement

Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

Participant Consent and Ethical Approval

The Declaration of Helsinki’s guiding principles were followed in the conduct of this work. The present study was approved by the local ethic committee (University of Naples Federico II), and informed consent was taken from the participants.

Disclosure

Matteo Megna acted as a speaker or consultant for Abbvie, Novartis, Eli Lilly, Janssen, UCB, Amgen, Leo Pharma; Gabriella Fabbrocini acted as a speaker or consultant for Abbvie, Novartis, Eli Lilly, Janssen, UCB, Amgen, Leo Pharma, Almirall. The remaining authors report no conflicts of interest in this work.

Additional information

Funding

There is no funding to report for this study.