Autoimmune diseases affect approximately 4.6% of the US population and are frequently managed with immunomodulatory therapies, including tumor necrosis factor-alpha (TNF-α) inhibitors. These biologic agents, such as infliximab, adalimumab, etanercept, golimumab, and certolizumab pegol, target TNF-α, a key cytokine involved in inflammatory signaling and bone remodeling. While TNF-α inhibitors have demonstrated efficacy in reducing disease activity across a range of autoimmune conditions, their impact on oral health and orthodontic treatment remains underexplored. Clinical studies suggest that TNF-α inhibitors can affect oral health, potentially altering risk of periodontitis, oral infections, and caries. TNF-α also plays a central role in orthodontic tooth movement (OTM), and animal studies suggest that TNF-α inhibition, whether local or systemic, can significantly reduce OTM and root resorption by suppressing osteoclast activity and altering cytokine signaling. This review synthesizes the clinical pharmacology of TNF-α inhibitors, current knowledge of their systemic and oral effects, and their potential influence on OTM.

We report the case of a 67-year-old female who presented with a history of asymptomatic rising of serum creatinine after receiving adalimumab therapy for rheumatoid arthritis (RA). A renal biopsy revealed granulomatous interstitial nephritis (GIN). After other causes of acute kidney injury were excluded, adalimumab was held, and steroid therapy was initiated. His kidney function improved. Based on this case report, adalimumab could be a rare cause of impaired kidney function and should not be considered a completely safe treatment or disregarded as a potential cause of renal complications, such as GIN, as diagnosed in our case.

Drug survival reflects the long-term effectiveness, safety, and tolerability of biologic therapies in routine clinical practice. To compare drug survival among currently available biologic classes in Japanese patients with psoriasis and to evaluate reason-specific discontinuation. We conducted a retrospective cohort study including 538 biologic treatment episodes from 311 patients treated at a tertiary dermatology centre in Japan. Tumour necrosis factor, interleukin-17, interleukin-23, and interleukin-12/23 inhibitors were compared. Overall drug discontinuation was assessed using multivariable Cox proportional hazards models with cluster-robust standard errors. Discontinuation due to ineffectiveness and adverse events was evaluated using Fine-Gray competing risk models. Compared with tumour necrosis factor inhibitors, interleukin-23 inhibitors were associated with more favourable overall drug survival (adjusted hazard ratio: 0.43, 95% confidence interval: 0.25-0.74; p=0.002), which remained significant in the 104-week analysis (hazard ratio: 0.50, 95% confidence interval: 0.28-0.91; p=0.023). Interleukin-17 inhibitors and ustekinumab did not differ significantly from tumour necrosis factor inhibitors in the primary analysis. In competing risk analyses, interleukin-23 inhibitors showed a lower risk of adverse event-related discontinuation than tumour necrosis factor inhibitors (subdistribution hazard ratio: 0.10, 95% confidence interval: 0.02-0.59; p=0.010), whereas no significant class differences were observed for ineffectiveness-related discontinuation. Interleukin-23 inhibitors showed the most favourable drug survival profile, primarily driven by reduced adverse event-related discontinuation.

The treatment of palmoplantar psoriasis (PPP), manifesting as hyperkeratotic plaques or pustular lesions (palmoplantar pustulosis -PPPP), is challenging. We aimed to evaluate the efficacy of various biologic treatments for PPP through a network meta-analysis. Systematic review and network meta-analysis of randomized controlled trials (RCTs) involving biologic treatments for adult patients with PPP or PPPP. Databases searched included PubMed, Embase, CENTRAL, Scopus, and trial registries (ClinicalTrials.gov, WHO ICTRP). The search was conducted from inception to May 2026. Studies comparing biologic agents were included. The primary outcome was the proportion of patients achieving ppPASI75 or equivalent PGA 0/1 at week 14-16. A Bayesian random-effects network meta-analysis was performed, reporting 95% credible intervals (CrI). 20 RCTs with 2,158 patients were included. Significant efficacy was observed for adalimumab (OR: 6.8, 95% CrI: 1.5-31), guselkumab 100 mg (OR: 7.4, 95% CrI: 2.0-2), ixekizumab (OR: 10.0, 95% CrI: 2.2-44), and secukinumab (OR: 6.1, 95% CrI: 1.7-27) compared to placebo. SUCRA values were highest for ixekizumab (87.2%), guselkumab 100 mg (84.1%), adalimumab (76.5%), and secukinumab (71.3%). Patients with exclusive palmoplantar involvement had a more challenging response to treatment. Biologic therapies offer significant improvement in managing PPP and PPPP. Specific biologic agents showed superior efficacy, allowing optimization of treatment strategies; however, these findings are based on indirect comparisons and heterogeneous populations, and should therefore be interpreted with caution. Future research should focus on direct comparisons, phenotype-specific trials, and long-term efficacy to enhance patient outcomes and quality of life.