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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
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Failure of Biologic Therapy in Psoriasis.

Rocío Cardona1, Natalia M Pelet Del Toro1, Eduardo Michelen-Gómez1

  • 1School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.

Puerto Rico Health Sciences Journal
|September 20, 2021
PubMed
Summary

Biologic therapy failure in psoriasis patients was common, with ineffectiveness being the primary reason for discontinuation. Insurance coverage also impacted the use of etanercept and ustekinumab.

Keywords:
Biologic switchingBiologic therapyBiologic therapy discontinuationBiologic therapy failurePsoriasis

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Area of Science:

  • Dermatology
  • Immunology
  • Pharmacology

Background:

  • Psoriasis is a chronic inflammatory skin condition.
  • Biologic therapies are effective treatments for moderate-to-severe psoriasis.
  • Understanding biologic therapy failure is crucial for optimizing patient care.

Purpose of the Study:

  • To determine the frequency of biologic therapy failure in psoriasis patients.
  • To identify patient demographics and characteristics associated with biologic therapy failure.
  • To analyze common reasons for discontinuing biologic treatments.

Main Methods:

  • Retrospective review of medical records for psoriasis patients.
  • Study period: January 1st, 2013, to May 1st, 2018.
  • Inclusion criteria: Patients who failed at least one biologic therapy.

Main Results:

  • Seventy-seven patients discontinued biologic therapy at least once.
  • Common comorbidities included hypertension (58.4%), diabetes (37.7%), and psoriatic arthritis (23.4%).
  • Most used biologics: Adalimumab (80.5%), Ustekinumab (70.1%), Etanercept (14.2%). Ustekinumab had the longest mean duration of use (17.0 months) before discontinuation.

Conclusions:

  • Ineffectiveness was the main reason for discontinuing biologic therapy.
  • Insurance coverage issues contributed to discontinuation of etanercept and ustekinumab.
  • No significant associations found between discontinuation and age, gender, or comorbidities; larger studies are needed.