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. 2022 Aug;36(8):1284-1291.
doi: 10.1111/jdv.18126. Epub 2022 Apr 12.

Prevalence and characterization of treatment-refractory psoriasis and super-responders to biologic treatment: a nationwide study

N Loft  1   2 , A Egeberg  1   3 , M K Rasmussen  4 , L E Bryld  5 , C V Nissen  3 , T N Dam  6 , K K Ajgeiy  7 , L Iversen  4 , L Skov  1   2
Affiliations

Prevalence and characterization of treatment-refractory psoriasis and super-responders to biologic treatment: a nationwide study

N Loft et al. J Eur Acad Dermatol Venereol. 2022 Aug.

Abstract

Introduction: Treatment with biologics often leads to clearance of psoriasis. However, some patients do repeatedly fail to respond and/or lose an achieved response (treatment refractory) to the biologic, whereas other patients achieve excellent response to one biologic and remain clear of psoriasis for several years (super-responders).

Objective: To identify and characterize patients with treatment refractory psoriasis and patients who are super-responders to biologic treatment.

Material and methods: Patients registered in DERMBIO between January 2007 and November 2019 were included. Patients were categorized as being treatment refractory if they had had treatment failure to ≥3 biologics targeting ≥2 different pathways. Super-responders were patients treated with their first biologic for minimum 5 years without an absolute psoriasis area and severity index (PASI) > 3 between 6 months and 5 years of treatment. All remaining patients from DERMBIO served as comparators.

Results: In total, 3280 patients were included with a mean age of 45.0 years. 1221 (37%) of the patients were females. Of the included patients, 214 (6.5%) were categorized as treatment refractory and 207 (6.3%) were categorized as super-responders. Treatment refractory patients had higher mean body weight (100.6 kg vs. 90.6 kg, P < 0.0001) and higher mean BMI (32.2 vs. 29.4, P < 0.0001) compared with the rest of patients in DERMBIO. Super-responders had higher socioeconomic status and fewer comorbidities compared with the comparator group (P < 0.0001).

Conclusion: A small proportion of patients with psoriasis treated with biologics are either super-responders or treatment refractory. Treatment refractory patients have higher body weight, whereas super-responders have fewer comorbidities and higher socioeconomic status.

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References

    1. Griffiths CEM, Armstrong AW, Gudjonsson JE, Barker J. Psoriasis. Lancet 2021; 397: 1301-1315.
    1. Loft N, Egeberg A, Rasmussen MK et al. Response to biologics during the first six months of therapy in biologic-naïve patients with psoriasis predicts risk of disease flares: a Danish nationwide study. Acta Dermato-Venereologica 2020; 101: adv00357.
    1. Piaserico S, Cazzaniga S, Chimenti S et al. Efficacy of switching between tumor necrosis factor-alfa inhibitors in psoriasis: results from the Italian Psocare registry. J Am Acad Dermatol 2014; 70: 257-262.e3.
    1. Ortonne JP, Chimenti S, Reich K et al. Efficacy and safety of adalimumab in patients with psoriasis previously treated with anti-tumour necrosis factor agents: subanalysis of BELIEVE. J Eur Acad Dermatol Venereol 2011; 25: 1012-1020.
    1. Yamauchi PS, Bissonnette R, Teixeira HD, Valdecantos WC. Systematic review of efficacy of anti-tumor necrosis factor (TNF) therapy in patients with psoriasis previously treated with a different anti-TNF agent. J Am Acad Dermatol 2016; 75: 612-618.e6.

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