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. 2024 Dec 24;13(1):5.
doi: 10.3390/biomedicines13010005.

Ten-Year Persistence of Biologic Drugs in Psoriasis and Its Relationship with Pharmacogenetic Biomarkers

Andrea Rodríguez-Lopez  1 , María Martínez-Sendino  1 , Rocío Prieto-Pérez  2 , Paula Soria-Chacartegui  1 , Eva González-Iglesias  1 , Mario Aparicio-Domínguez  3 , Sonsoles Berenguer-Ruiz  3 , Esteban Daudén  3 , Francisco Abad-Santos  1   4
Affiliations

Ten-Year Persistence of Biologic Drugs in Psoriasis and Its Relationship with Pharmacogenetic Biomarkers

Andrea Rodríguez-Lopez et al. Biomedicines. .

Abstract

Background: Psoriasis is a skin disease characterized by the presence of erythematous, scaly plaques on the extensor surfaces of the body. Treatment varies according to the stage of the disease, with the most severe cases being treated with biologic treatments that differ in efficacy and persistence over time. This study aimed to evaluate the 10-year persistence of biologic drugs (adalimumab, etanercept, infliximab and ustekinumab) in the treatment of moderate-to-severe plaque psoriasis. Methods: A total of 143 patients (61 women and 82 men) were evaluated; data were collected from the electronic clinical history, and statistical analysis was performed using the SPSS program. In addition, 115 of them were genotyped in a previous study for 173 immune system genetic polymorphisms. Results: The persistence of biologic drugs at 10 years was 25.9% (95% CI: 17.2-34.5%). Adalimumab was the most persistent drug (41.5%), followed by ustekinumab (34.8%), infliximab (28%) and etanercept (9.3%). The main reason for discontinuation was insufficient efficacy (51%). Adalimumab allowed an increase in the dosing interval in 82.4% of patients who persisted and ustekinumab allowed an increase in 37.5%. The 10-year persistence was related to sex (higher in men, p < 0.001), biologic drug (p = 0.002) and polymorphisms in LMO4 (rs983332) (p = 0.014) and IL20RA (rs1167846) (p = 0.013). Conclusion: The results show that 25% of psoriasis patients treated with first-line biologics persisted at 10 years.

Keywords: biologic therapies; loss of efficacy; persistence; pharmacogenetic biomarkers; psoriasis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow-chart of patients initiating treatment with biologics for psoriasis according to the drug prescribed as first-line treatment and showing the second and third options in patients who discontinued. Of the patients that interrupted their treatment, only those who switched to one of the other three alternative drugs in this research are shown.
Figure 2
Figure 2
The 10-year persistence and discontinuation by insufficient efficacy according to prescription of biologics drugs as first-line or second- and third-line options. ADA: adalimumab; ETN: etanercept; INF: infliximab; UST: ustekinumab.
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