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Biologic fatigue in psoriasis.

Ethan C Levin1, Rishu Gupta, Gabrielle Brown

  • 1Department of Dermatology, University of California, Psoriasis and Skin Treatment Center , San Francisco, CA , USA.

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Summary
This summary is machine-generated.

Biologic fatigue, a loss of efficacy in psoriasis treatment, affects 20-32% of patients. Infliximab use may be linked to higher rates of biologic fatigue, necessitating further research into risk factors and antibody assays.

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Area of Science:

  • Dermatology
  • Immunology
  • Pharmacology

Background:

  • Biologic medications represent a significant advancement in psoriasis therapy over the last 15 years.
  • Long-term use of these therapies can lead to a diminished response, termed biologic fatigue.
  • Understanding and managing biologic fatigue is crucial for sustained patient treatment outcomes.

Purpose of the Study:

  • To review existing data on biologic fatigue in psoriasis.
  • To identify strategies for optimizing the management of patients on biologic therapies.
  • To minimize the occurrence and impact of biologic fatigue.

Main Methods:

  • Review of phase III clinical trials for biologic psoriasis treatments.
  • PubMed literature search for studies assessing loss of response to biologic therapy.
  • Analysis of patient response rates and associated factors.

Main Results:

  • Phase III trials indicate 20-32% of patients lose their PASI-75 response within 0.8-3.9 years.
  • Infliximab treatment showed the highest loss of response (32%) at the shortest follow-up (0.8 years).
  • Antidrug antibodies were associated with loss of response for infliximab and adalimumab, though not consistently reported.

Conclusions:

  • Biologic fatigue appears more prevalent with infliximab use.
  • Further research is required to pinpoint risk factors for biologic fatigue.
  • Development of effective antidrug antibody assays is needed for better patient management.