We are pleased that the British Association of Dermatologists guidelines on use of biological therapies in psoriasis1 have been highlighted and summarized so succinctly. We are also glad that the reviewing author, Dr Nijsten,2 found them to be “clear and informative” and that he recommends their use. However, we are concerned that his conclusion (as stated in the abstract and in the commentary) that “etanercept is the biological drug of choice in most eligible patients with stable disease with or without psoriatic arthritis” is a misrepresentation of what is stated in the guidelines. Indeed, we were very careful not to provide explicit guidance as to which of the agents covered (etanercept, infliximab, and efalizumab) should be the preferred choice given the lack of evidence available at the time.
Smith CH, Ormerod AD. British Guidelines on the Use of Biological Therapies for Psoriasis: A Note of Clarification on the Role of Etanercept. Arch Dermatol. 2007;143(12):1589-1603. doi:10.1001/archderm.143.12.1595-b