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. 2023 Nov;89(5):974-983.
doi: 10.1016/j.jaad.2023.06.058. Epub 2023 Jul 24.

Sociodemographic and clinical characteristics associated with multiple biologic failure in psoriasis: A 2015-2022 prospective cohort analysis of the CorEvitas psoriasis registry

Joy Q Jin  1 , Angel Cronin  2 , Carla Roberts-Toler  2 , Samuel Yeroushalmi  3 , Edward Hadeler  3 , Riley K Spencer  3 , Kareem G Elhage  3 , George Gondo  4 , Elizabeth B Wallace  5 , Soumya M Reddy  6 , George Han  7 , Jessica Kaffenberger  8 , Mitchell S Davis  3 , Marwa Hakimi  3 , Jose U Scher  6 , April W Armstrong  9 , Tina Bhutani  3 , Robert R McLean  2 , Wilson Liao  10
Affiliations
Free article

Sociodemographic and clinical characteristics associated with multiple biologic failure in psoriasis: A 2015-2022 prospective cohort analysis of the CorEvitas psoriasis registry

Joy Q Jin et al. J Am Acad Dermatol. 2023 Nov.
Free article

Abstract

Background: Psoriasis patients with poor therapeutic response to multiple biologic agents are not well-characterized.

Objective: To describe the characteristics associated with development of multiple biologic failure (MBF) versus good clinical response (GR) to the first biologic.

Methods: This prospective cohort analysis evaluated patients in the multicenter CorEvitas Psoriasis Registry who initiated their first biologic between 2015 and 2020 and were followed for ≥24 months. Multivariable logistic regression identified sociodemographic, clinical, and patient-reported outcomes that differed between MBF (discontinued ≥2 biologics of different classes, each used for ≥90 days, due to inadequate efficacy) and GR (continued use of first biologic for ≥2 years) patients.

Results: One thousand thirty-nine patients were analyzed (490 GR [47.2%], 65 MBF [6.3%]). Female sex, shorter psoriasis duration, earlier year of biologic initiation, prior nonbiologic systemic therapy use, history of hyperlipidemia, and Medicaid insurance were significantly associated with MBF, though the latter 2 variables exhibited wider confidence intervals, indicating a lower level of support. The first-to-second biologic sequence most observed with MBF was Tumor necrosis factor-α inhibitor to IL-17 inhibitor use.

Limitations: Biologic adherence between visits was not evaluated.

Conclusion: Approximately 6% of psoriasis patients met MBF criteria. The results identify characteristics associated with MBF that may distinguish patients warranting more frequent follow-up.

Keywords: biologic; biologic failure; biological agent; multiple biologic failure; prospective cohort study; psoriasis; systemic therapy; therapeutic failure; treatment characteristics.

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Conflict of interest statement

Conflicts of interest J.Q.J. has received research grant funding from the National Psoriasis Foundation and institutional funding from the University of California, San Francisco. A.C., C.R.T., and R.R.M. are employees of CorEvitas, LLC. E.B.W. has served as an investigator for Pfizer and Target RWE. S.R has served as an advisor for UCB, Novartis, Amgen, Fresenius Kabi, Abbvie, and Janssen. G.H. has received honoraria or research grants from AbbVie, Amgen, Arcutis, Athenex, Bausch Health, Boehringer Ingelheim, Bond Avillion, Bristol Myers Squibb, Celgene Corporation, Dermavant, DermTech, Eli Lilly and Company, EPI Health, Janssen Pharmaceuticals, LEO Pharma, MC2 Therapeutics, Novartis, Ortho Dermatologics, PellePharm, Pfizer, Regeneron Pharmaceuticals, Sanofi Genzyme, SUN Pharmaceutical Industries Ltd, and UCB. J.U.S. has received research grant funding from the National Psoriasis Foundation, Pfizer and Janssen and has served as a consultant for Janssen, Abbvie, Novartis, Sanofi, UCB and BMS. A.W.A. has served as a research investigator and/or scientific advisor to AbbVie, Almirall, Arcutis, ASLAN, Beiersdorf, BI, BMS, Dermavant, Dermira, EPI, Incyte, Janssen, Leo, Lilly, Modmed, Nimbus, Novartis, Ortho Dermatologics, Pfizer, Regeneron, Sanofi, Sun and UCB. T.B. has received research grant funding from Novartis and Regeneron and is a principal investigator for trials sponsored by Abbvie, Castle, CorEvitas, Dermavant, Galderma, Mindera, and Pfizer. T.B. has served as an advisor for Abbvie, Arcutis, Boehringer-Ingelheim, Bristol Myers Squibb, Janssen, Leo, Lilly, Novartis, Pfizer, Sun, and UCB. W.L. has received research grant funding from Abbvie, Amgen, Janssen, Leo, Novartis, Pfizer, Regeneron, and TRex Bio. The remaining authors have nothing to disclose.

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