Table 2.

Expert consensus recommendations for biologics

Parameters	Etanercept	Infliximab	Adalimumab	Secukinumab
Dose and dosing frequency	50 mg per week subcutaneously (s.c) for 12 weeks, followed by 25 mg once or twice a week. Minimum 12 weeks, till clearance of skin and/or affordability.	5 mg/kg at day 0, week 2, week 6, followed by every 8-12 weeks dosing. 6-8 weeks for clearance and can be maintained depending upon affordability.	80 mg: day 0, 40 mg at week 1, followed by 40 mg every 2 weeks s.c 6-8 weeks for clearance and can be maintained depending upon affordability.	300 mg sc at week 0, 1, 2,3, and 4 weeks followed by monthly dosing of 300 mg (150 mg after 6 months in case of economic constraints). 4-6 weeks for clearance and can be maintained depending upon affordability.
Efficacy	PASI 50 response by 8-12 weeks. PASI 90/100 response is not achieved Maximum efficacy reached is PASI 75 response.	PASI 50 response by 2 weeks. PASI 90/100 response 6 weeks but limited experience.	PASI 50 response by week 4. PASI 90/100 response by 12 weeks.	PASI 50 response by 2-4 weeks. PASI 90-100 response by 4-8 weeks.
Concomitant Medications indicated	Methotrexate/acitretin	Methotrexate low dose	Methotrexate low dose	Generally, not required
Remission Maintained	12 weeks	6 to 8 weeks	6 to 8 weeks	16-24 weeks
Safety	TB and other infections risk are greater with TNF inhibitors Infusion reactions are very common with infliximab			Secukinumab has a better safety profile compared to other biologics. Candidiasis is commonly seen with secukinumab in the initial stages of therapy