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Adalimumab for Adult Patients with Plaque Psoriasis: A Review of Clinical Effectiveness

Last updated: June 22, 2020
Project Number: RC1274-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of adalimumab versus other biologic drugs in adult patients with plaque psoriasis?

Key Message

Evidence from five systematic reviews (four with network meta-analysis and one with traditional meta-analysis) and one randomized controlled trial suggested that adalimumab was less effective than infliximab, ixekizumab, risankizumab, and secukinumab in achieving skin clearance and improvements in health-related quality of life in patients diagnosed with moderate-to-severe plaque psoriasis. Apart from the randomized controlled trial comparing adalimumab to risankizumab, separate data from direct comparison were not available for effectiveness and safety. There was not enough evidence to draw a firm conclusion about the comparative safety of adalimumab versus the other biologics of interest. Substantial overlap of primary studies across the systematic reviews showed that the pooled estimates from the separate reviews contain some data from the same primary studies. An assessment of the methodological quality of the included studies did not find issues that present significant uncertainty about the findings in four systematic reviews and the randomized controlled trial. The quality of one systematic review was limited due to inadequate reporting. However, the results from that study were consistent with the others. Thus, they did not appear likely to impact the overall evidence reported here. The consistency could be due to the overlap of the primary studies included in the systematic reviews.