In terms of body-weight subgroups, the decrease from baseline to follow-up in mean BSA, PGA, and composite BSA×PGA scores was approximately equivalent between patients who were ≤200 lb vs >200 lb at baseline (Figure 1, middle). Overall, body weight remained relatively stable from baseline to follow-up (Figure 5), eliminating the possibility of long-term weight changes as a confounding factor in this analysis.
Improvements in disease severity assessments were observed regardless of the target pathway of the biologic that was prescribed (Figure 1, bottom). Biologics that targeted IL-12/23, IL-17, or TNFα pathways were all successful in reducing the mean BSA, PGA, and composite BSA×PGA scores. TNF inhibitors were slightly less efficacious in all categories evaluated.
The efficacy of biologic treatment resulted in an 86.9% improvement in psoriasis disease activity in the overall population, with comparable rates of improvement being observed in each of the subgroups (Figure 2). The mean affected BSA at baseline of 13.3% was substantially higher than the NPF TTT goal of ≤1%. However, at follow-up, 67.0% of the entire population had achieved the TTT goal for BSA, and the ability of the biologic therapy to help patients achieve the TTT goal was relatively consistent across all subgroups (Figure 3).
Safety Assessments
Few AEs were reported (Table 2). There were 25 AEs in 19 (19.0%) patients. The most frequently reported AEs were bronchitis (4.0%) and upper respiratory infection (4.0%).
DISCUSSION
This retrospective study examined the clinical benefits of biologic therapy for psoriasis in a real-world setting in a population consisting mostly (90%) of individuals with moderate-to-severe disease. As would be expected in a real-world setting, the study population was heterogeneous and included subgroups of patients with and without prior experience using biologics, patients varying in body weight, and a wide range of biologics prescribed (9 different ones) at the beginning of the study. The mixed characteristics of this population provided a unique opportunity to assess the long-term effectiveness of biologics in treating moderate-to-severe psoriasis while accounting for several known factors that might influence the choice (and results) of therapeutic interventions in actual dermatology practice.
Overall, the results from this chart review demonstrated that biologic therapy was safe and effective. Biologic therapy resulted in improvements in all assessed disease severity measures when evaluated 4 to 12 months after initiating treatment. There were notable reductions in BSA, PGA scores, and composite BSA×PGA scores, which, in the aggregate, corresponded with a >85% improvement in the extent and severity of psoriatic lesions in the pooled population. The success of biologic intervention within this population was further evident from the observation that the majority (67%) of patients achieved the NPF TTT goal of ≤1% affected BSA. These results are consistent with findings from numerous randomized, controlled trials that have compared the efficacy of these biologics individually against placebo and provide further support for their use in clinical practice.
We performed subgroup analyses to determine if certain variables that are believed to affect treatment outcomes modulated the efficacy of biologic intervention in this population. Surprisingly, none of these variables seemed to affect the efficacy of biologic intervention within the assessed time frame.
Despite evidence suggesting that body weight can affect the efficacy of biologic treatment, we did not observe an effect of weight on any of the assessed measures. In this population, biologic efficacy was equivalent in patients with relatively high vs relatively low body weight. The consistency of body weight during the present study is all the more remarkable because some biologics are known to be associated with weight gain, which in turn can negatively impact disease progression and treatment outcomes.
Patients’ prior experience with biologics can sometimes influence the response to subsequent treatment regimens that incorporate the same or different biologic regimens. In the present study, we did not observe a negative effect of prior experience with biologics on treatment outcomes. Additionally, very few patients switched or discontinued biologic treatment during the study period, suggesting that the patients and their dermatologists were satisfied with the management of their disease symptoms, regardless of their prior treatment experiences.
Several different classes of biologics were prescribed to the patients in this study. These biologics were categorized as targeting IL-12/23, IL-17, or TNFα pathways. Regardless of the
Overall, the results from this chart review demonstrated that biologic therapy was safe and effective. Biologic therapy resulted in improvements in all assessed disease severity measures when evaluated 4 to 12 months after initiating treatment. There were notable reductions in BSA, PGA scores, and composite BSA×PGA scores, which, in the aggregate, corresponded with a >85% improvement in the extent and severity of psoriatic lesions in the pooled population. The success of biologic intervention within this population was further evident from the observation that the majority (67%) of patients achieved the NPF TTT goal of ≤1% affected BSA. These results are consistent with findings from numerous randomized, controlled trials that have compared the efficacy of these biologics individually against placebo and provide further support for their use in clinical practice.
We performed subgroup analyses to determine if certain variables that are believed to affect treatment outcomes modulated the efficacy of biologic intervention in this population. Surprisingly, none of these variables seemed to affect the efficacy of biologic intervention within the assessed time frame.
Despite evidence suggesting that body weight can affect the efficacy of biologic treatment, we did not observe an effect of weight on any of the assessed measures. In this population, biologic efficacy was equivalent in patients with relatively high vs relatively low body weight. The consistency of body weight during the present study is all the more remarkable because some biologics are known to be associated with weight gain, which in turn can negatively impact disease progression and treatment outcomes.
Patients’ prior experience with biologics can sometimes influence the response to subsequent treatment regimens that incorporate the same or different biologic regimens. In the present study, we did not observe a negative effect of prior experience with biologics on treatment outcomes. Additionally, very few patients switched or discontinued biologic treatment during the study period, suggesting that the patients and their dermatologists were satisfied with the management of their disease symptoms, regardless of their prior treatment experiences.
Several different classes of biologics were prescribed to the patients in this study. These biologics were categorized as targeting IL-12/23, IL-17, or TNFα pathways. Regardless of the
