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Updated: Sep 25, 2025
11:39
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
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Time to Relapse After Discontinuing Systemic Treatment for Psoriasis: A Systematic Review
Marie Masson Regnault1, Jason Shourick2, Fatma Jendoubi3
1Department of Dermatology, CHU Poitiers (University Hospital Centre), 2, rue de la Milétrie, 86000, Poitiers, France. m.massonregnault@gmail.com.
American Journal of Clinical Dermatology
|April 30, 2022
Summary
Systemic psoriasis treatment relapse occurs sooner with traditional drugs than biologics. Interleukin-23 (IL-23) antagonists show the longest remission duration after stopping treatment.
Area of Science:
- Dermatology
- Pharmacology
- Systemic Treatments
Background:
- Determining optimal discontinuation timing for systemic psoriasis therapy post-remission is crucial.
- This systematic review evaluates relapse timelines following cessation of systemic psoriasis treatments.
Approach:
- Systematic literature searches of PubMed, Cochrane Library, and Embase were conducted for relevant randomized controlled trials.
- Data on time to relapse and drug discontinuation were extracted, considering psoriasis control and relapse definitions.
- Pharmaceutical companies were contacted for supplementary data.
Key Points:
- Thirty articles were reviewed, covering conventional systemic agents, TNF antagonists, IL-17 antagonists, IL-12/23 or IL-23 antagonists, and other targeted therapies.
- Relapse occurred faster with conventional systemic treatments (approx. 4 weeks) compared to biologics (12-34 weeks) at 50% PASI improvement loss.
- Stringent criteria (PASI 90 loss) showed longer relapse times for IL-23 antagonists (21-42 weeks) versus IL-17 antagonists (7-24 weeks).
Conclusions:
- Biological agents demonstrate longer remission periods than oral systemic agents after discontinuation.
- Interleukin-23 (IL-23) antagonists are associated with the most extended relapse-free intervals among biologics.
- Findings support informed selection of systemic agents for intermittent psoriasis management strategies.
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