What’s already known about this topic?

The use of indirect comparison (IC) methodologies to compare the efficacy and safety of multiple interventions for psoriasis is growing, and methods used to perform these analyses are diversifying, making it increasingly difficult for dermatologists to keep abreast of the available data and to fully understand the perspective, methods and quality of each individual analysis.

What does this study add?

This review identified some consistency in short-term efficacy rankings for certain systemic biologic drugs for the treatment of psoriasis, although rankings for most drugs varied by IC. Factors potentially affecting efficacy outcomes varied considerably across all ICs.

In psoriasis, ICs do not yet provide sound comparative safety or long-term efficacy information of value to physicians; however, long-term efficacy data should be forthcoming from clinical trials in the near future.

What are the clinical implications of this work?

Considerable variation in factors potentially affecting efficacy outcomes across ICs means a detailed understanding of the scope and conduct of each IC is crucial prior to using its findings to inform clinical decisions.

Treatment rankings need to be interpreted alongside actual differences in outcomes to allow conclusions on clinical relevance. Drugs within a class cannot be considered equal in terms of efficacy and, therefore, should be considered individually.