LAUSR

Dear Editor, Biosimilar therapies are an emerging option in the treatment of psoriasis and other immune-mediated diseases due to the lower impact on public health costs. SB5, commercially known as Imraldi (Samsung Bioepsis), is approved in Europe for the treatment of the same clinical indications of the reference adalimumab (Humira-AbbVie). Phase III trials in rheumatoid arthritis (RA) showed a similar clinical efficacy, safety and tolerability profile of SB5 vs adalimumab and in patients switched to SB5 from adalimumab. However, no clinical published data exist so far in patients with psoriasis. As for regulatory policies, in Tuscany, from October 17, 2018, due to patent loss of adalimumab reference, all patients in current treatment with adalimumab originator, after signing an informed consent form, were switched to SB5. Indeed, SB5 was the available adalimumab biosimilar drug in case of new adalimumab prescriptions. We report our experience on 23 patients who received subcutaneous injections of SB5 at standard protocols for at least 12 weeks (Table 1). All patients had cutaneous psoriasis and almost 61% of patients had concurrent psoriatic arthritis (PsA), with axial involvement in 5/23 cases. Shift from reference drug was performed in the majority of patients (20/23), while in the remaining three patients, SB5 was chosen as rescue drug in 2/3 patients after loss of PsA response to etanercept, or first line treatment in a case of moderate-to-severe psoriasis (psoriasis area severity index (PASI) 14.5). No relevant changes in PASI score were observed in 90% of patients who were switched from originator. In 2/20 patients, loss of