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Outcomes in patients with psoriasis after treatment with biologics for ≥10 consecutive years
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Biologic treatments have improved outcomes in patients with psoriasis, but data on patient and treatment characteristics and outcomes in long-term users are limited. A study published by Henckens et al. in Clinical and Experimental Dermatology explored data from patients who had received continuous treatment with the same biologic for ≥10 years (ultra-long biologic users; N = 118). Data were gathered from the BioCAPTURE multicenter registry (N = 1,377) which included patients in the Netherlands with psoriasis who received treatment with biologics or small-molecule inhibitors. The highest proportion of ultra-long users received ustekinumab (37.1%), followed by adalimumab (24.2%), etanercept (14.8%), and infliximab (6.3%). |
| Key learnings |
| 66.1% of ultra-long users did not require additional systemic antipsoriatic treatment. Dose adjustments were common; 40.7% of patients required dose reductions, 29.7% required escalations, and 13.6% of patients required both. 69.5% of patients had at least one comorbidity. |
| The median PASI score decreased from 11.4 at the start of treatment to 2.7 at Month 6, remaining stable throughout subsequent treatment at a score of ≤3. Complete clearance (PASI 100) was rare, in 3.9% of patients at Month 6. |
| 62.3% of patients remained on the same biologic after 15 years. Discontinuation reasons included loss of efficacy (9.3%) and adverse events (7.6%; lung cancer, AML, and heart failure). |
| This study demonstrates that long-term biologic use is feasible even in patients with multiple comorbidities, and provides clinicians with important evidence on ultra-long treatment with biologics. |
Abbreviations: AML, acute myeloid leukemia; PASI, Psoriasis Area and Severity Index.
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