Unveiling the effectiveness and safety spectrum of biologic therapies in psoriasis: a three-year real-world analysis

Abstract

Background: Psoriasis vulgaris is a chronic immune-mediated inflammatory disease that significantly affects quality of life, particularly in severe cases and anatomically challenging areas. Biologic therapies targeting immune pathways have improved clinical outcomes; however, variability in effectiveness, safety, and drug survival necessitates further investigation.

Objectives: This study aimed to evaluate the effectiveness, safety, and drug survival of biologic therapies in patients with moderate-to-severe psoriasis vulgaris.

Methods: A retrospective cohort study was conducted on 400 psoriasis patients treated with IL-17, IL-12/23, and IL-23 inhibitors. Clinical outcomes were assessed using PASI, DLQI, PSSI, NAPSI, and ppPASI scores. Kaplan-Meier survival analysis and Cox regression were employed to identify predictors of drug survival.

Results: Ixekizumab demonstrated superior effectiveness in achieving PASI 100 and improving scalp psoriasis, while Guselkumab provided the most sustained improvements in palmoplantar and nail involvement. Adverse events were most frequently associated with IL-17 inhibitors, particularly upper respiratory tract infections. Guselkumab and Secukinumab demonstrated the highest drug survival rates, whereas Ixekizumab had the lowest. Early improvements in PASI and DLQI scores were strong predictors of drug survival.

Conclusion: Personalized treatment approaches are crucial, given the varied effectiveness, safety profiles, and drug survival among biologic therapies.

Keywords: Psoriasis vulgaris; biologic agents; drug safety; patient outcomes; treatment effectiveness.