What are the once weekly medication options for treating psoriasis?

From the Guidelines

Etanercept (Enbrel) is a suitable once-weekly medication option for treating psoriasis, administered as a 50mg subcutaneous injection once weekly after an initial loading period of 50mg twice weekly for 12 weeks. This recommendation is based on the joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics 1. The guidelines outline the approved dosing of etanercept in psoriasis, which supports its use as a once-weekly medication option.

Key Considerations

• Etanercept is a TNF-alpha inhibitor that has been shown to be effective in treating moderate-to-severe plaque psoriasis 1.
• The medication is administered subcutaneously, and the dosing schedule is straightforward, making it a convenient option for patients.
• As with any biologic medication, regular monitoring is necessary to check for potential side effects, such as injection site reactions and increased infection risk.

Comparison with Other Options

• Other biologic medications, such as ustekinumab (Stelara) and adalimumab (Humira), have different dosing schedules and may be considered as alternative options for treating psoriasis 1.
• However, etanercept remains a viable option, particularly for patients who have failed to respond to other treatments or have contraindications to other medications.

Clinical Decision-Making

• The choice of medication should be individualized based on patient factors, such as disease severity, medical history, and patient preference.
• A dermatologist should determine the most appropriate treatment option, taking into account the latest guidelines and evidence-based recommendations 1.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION Enbrel is administered by subcutaneous injection. Patient PopulationRecommended Dose and Frequency Adult RA and PsA (2.3)50 mg once weekly with or without methotrexate (MTX) AS (2.3)50 mg once weekly Adult PsO (2. 3)50 mg twice weekly for 3 months, followed by 50 mg once weekly

• Once weekly medication options for treating psoriasis include:
  • Etanercept (Enbrel) 50 mg once weekly after initial 3 months of 50 mg twice weekly 2 Note that the initial dose for adult PsO is 50 mg twice weekly for 3 months, then 50 mg once weekly.

From the Research

Once Weekly Medication Options for Treating Psoriasis

There are no once weekly medication options mentioned in the provided studies for treating psoriasis. However, the following biologic agents are discussed as treatment options:

• Adalimumab, which is administered every other week (eow) 3, 4, 5
• Other biologic agents such as ustekinumab, interleukin-17 inhibitors, and guselkumab are mentioned, but their administration schedules are not specified 6, 7

Administration Schedules

The administration schedules mentioned in the studies are:

• Adalimumab 40 mg every other week (eow) 3, 4, 5
• Adalimumab 0.8 mg/kg (to a maximum of 40 mg) every other week (eow) in pediatric patients 3

Treatment Options

The studies discuss the following treatment options for moderate to severe psoriasis:

• Biologic agents such as adalimumab, ustekinumab, interleukin-17 inhibitors, and guselkumab 6, 7
• Systemic treatments such as acitretin, cyclosporine, methotrexate, apremilast, and infliximab 7
• Lifestyle interventions and recommendations for the use, screening, and monitoring of systemic therapies 7