Psoriasis

Key clinical point: Switching biologics in patients with psoriasis was mostly impelled by secondary lack of efficacy for skin symptoms with young age and the presence of psoriatic arthritis (PsA) linked to a higher frequency of switching in the long-term.

Major finding: Switching of first- and second-line biologics was likely attributed to a secondary lack of efficacy for skin disease. Each unit increase in age decreased the likelihood of switching twice or more by 4% (odds ratio [OR], 0.964; P = .038), whereas the existence of PsA increased the likelihood by 2.69-fold (OR, 2.69; P = .026).

Study details: This was a retrospective study including 115 adult patients with psoriasis who had been receiving biologics for 12 consecutive months or more and underwent at least a single biologic switch.

Disclosures: No specific funding for the study was disclosed. The authors declared no potential conflict of interests.

Source: Akdogan N et al. Expert Rev Clin Pharmacol. 2021 Sep 23. doi: 10.1080/17512433.2021.1979394.

Key clinical point: Switching biologics in patients with psoriasis was mostly impelled by secondary lack of efficacy for skin symptoms with young age and the presence of psoriatic arthritis (PsA) linked to a higher frequency of switching in the long-term.

Major finding: Switching of first- and second-line biologics was likely attributed to a secondary lack of efficacy for skin disease. Each unit increase in age decreased the likelihood of switching twice or more by 4% (odds ratio [OR], 0.964; P = .038), whereas the existence of PsA increased the likelihood by 2.69-fold (OR, 2.69; P = .026).

Study details: This was a retrospective study including 115 adult patients with psoriasis who had been receiving biologics for 12 consecutive months or more and underwent at least a single biologic switch.

Disclosures: No specific funding for the study was disclosed. The authors declared no potential conflict of interests.

Source: Akdogan N et al. Expert Rev Clin Pharmacol. 2021 Sep 23. doi: 10.1080/17512433.2021.1979394.

Key clinical point: Switching biologics in patients with psoriasis was mostly impelled by secondary lack of efficacy for skin symptoms with young age and the presence of psoriatic arthritis (PsA) linked to a higher frequency of switching in the long-term.

Major finding: Switching of first- and second-line biologics was likely attributed to a secondary lack of efficacy for skin disease. Each unit increase in age decreased the likelihood of switching twice or more by 4% (odds ratio [OR], 0.964; P = .038), whereas the existence of PsA increased the likelihood by 2.69-fold (OR, 2.69; P = .026).

Study details: This was a retrospective study including 115 adult patients with psoriasis who had been receiving biologics for 12 consecutive months or more and underwent at least a single biologic switch.

Disclosures: No specific funding for the study was disclosed. The authors declared no potential conflict of interests.

Source: Akdogan N et al. Expert Rev Clin Pharmacol. 2021 Sep 23. doi: 10.1080/17512433.2021.1979394.

Key clinical point: This real-life study showed reduced efficacy of guselkumab for over 36 weeks in patients with moderate-to-severe chronic plaque psoriasis than previously reported, with body weight and exposure to biologics being the major predictors of response.

Major finding: At week 36, 67% of patients achieved Psoriasis Area Severity Index (PASI) 75 with heavier vs. low‐weight patients showing a decreased likelihood of achieving PASI 75 until week 4 (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.88-0.99). Even at week 36, PASI 75 response rates were lower for patients exposed to 1 (OR, 0.07; 95% CI, 0.00-0.68) or more than 1 (OR, 0.00; 95% CI, 0.00-0.044) biologics than for biologic-naïve patients.

Study details: Findings are from a multicenter retrospective cohort study including 135 adult patients with moderate-to-severe chronic plaque psoriasis.

Disclosures: The study was supported by the Chang Gung Memorial Hospital and National Taiwan University Hospital, Hsin-Chu branch. Some of the authors declared serving as clinical trial participant or receiving speaker/consultancy honoraria from various sources.

Source: Hung YT et al. Ther Adv Chronic Dis. 2021 Sep 29. doi: 10.1177/20406223211046685.

Key clinical point: This real-life study showed reduced efficacy of guselkumab for over 36 weeks in patients with moderate-to-severe chronic plaque psoriasis than previously reported, with body weight and exposure to biologics being the major predictors of response.

Major finding: At week 36, 67% of patients achieved Psoriasis Area Severity Index (PASI) 75 with heavier vs. low‐weight patients showing a decreased likelihood of achieving PASI 75 until week 4 (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.88-0.99). Even at week 36, PASI 75 response rates were lower for patients exposed to 1 (OR, 0.07; 95% CI, 0.00-0.68) or more than 1 (OR, 0.00; 95% CI, 0.00-0.044) biologics than for biologic-naïve patients.

Study details: Findings are from a multicenter retrospective cohort study including 135 adult patients with moderate-to-severe chronic plaque psoriasis.

Disclosures: The study was supported by the Chang Gung Memorial Hospital and National Taiwan University Hospital, Hsin-Chu branch. Some of the authors declared serving as clinical trial participant or receiving speaker/consultancy honoraria from various sources.

Source: Hung YT et al. Ther Adv Chronic Dis. 2021 Sep 29. doi: 10.1177/20406223211046685.

Key clinical point: This real-life study showed reduced efficacy of guselkumab for over 36 weeks in patients with moderate-to-severe chronic plaque psoriasis than previously reported, with body weight and exposure to biologics being the major predictors of response.

Major finding: At week 36, 67% of patients achieved Psoriasis Area Severity Index (PASI) 75 with heavier vs. low‐weight patients showing a decreased likelihood of achieving PASI 75 until week 4 (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.88-0.99). Even at week 36, PASI 75 response rates were lower for patients exposed to 1 (OR, 0.07; 95% CI, 0.00-0.68) or more than 1 (OR, 0.00; 95% CI, 0.00-0.044) biologics than for biologic-naïve patients.

Study details: Findings are from a multicenter retrospective cohort study including 135 adult patients with moderate-to-severe chronic plaque psoriasis.

Disclosures: The study was supported by the Chang Gung Memorial Hospital and National Taiwan University Hospital, Hsin-Chu branch. Some of the authors declared serving as clinical trial participant or receiving speaker/consultancy honoraria from various sources.

Source: Hung YT et al. Ther Adv Chronic Dis. 2021 Sep 29. doi: 10.1177/20406223211046685.

Key clinical point: Patients with positive fecal immunochemistry test (FIT) results showed a significantly higher risk for psoriasis than those who were FIT-negative.

Major finding: During a 6.68-year median follow-up, the incidence rate of psoriasis per 1000 person-years was higher for the FIT-positive vs the FIT-negative group (4.14 vs 3.76). After multivariable adjustment, the adjusted hazard ratios for psoriasis were 1.029 (95% confidence interval [CI], 0.997-1.061), 1.118 (95% CI, 1.04-1.201), and 1.342 (95% CI, 1.157-1.557) for 1, 2, and 3 positive FIT results, respectively, vs negative FIT results.

Study details: Findings are from a retrospective nationwide population-based study of 1,395,147 participants aged 50 years or above who underwent screening for colorectal cancer.

Disclosures: The study was supported by the New Faculty Startup Fund from Seoul National University. The authors declared no potential conflict of interests.

Source: Lee HJ et al. Dermatology. 2021 Sep 16. doi: 10.1159/000518625.

Key clinical point: Patients with positive fecal immunochemistry test (FIT) results showed a significantly higher risk for psoriasis than those who were FIT-negative.

Major finding: During a 6.68-year median follow-up, the incidence rate of psoriasis per 1000 person-years was higher for the FIT-positive vs the FIT-negative group (4.14 vs 3.76). After multivariable adjustment, the adjusted hazard ratios for psoriasis were 1.029 (95% confidence interval [CI], 0.997-1.061), 1.118 (95% CI, 1.04-1.201), and 1.342 (95% CI, 1.157-1.557) for 1, 2, and 3 positive FIT results, respectively, vs negative FIT results.

Study details: Findings are from a retrospective nationwide population-based study of 1,395,147 participants aged 50 years or above who underwent screening for colorectal cancer.

Disclosures: The study was supported by the New Faculty Startup Fund from Seoul National University. The authors declared no potential conflict of interests.

Source: Lee HJ et al. Dermatology. 2021 Sep 16. doi: 10.1159/000518625.

Key clinical point: Patients with positive fecal immunochemistry test (FIT) results showed a significantly higher risk for psoriasis than those who were FIT-negative.

Major finding: During a 6.68-year median follow-up, the incidence rate of psoriasis per 1000 person-years was higher for the FIT-positive vs the FIT-negative group (4.14 vs 3.76). After multivariable adjustment, the adjusted hazard ratios for psoriasis were 1.029 (95% confidence interval [CI], 0.997-1.061), 1.118 (95% CI, 1.04-1.201), and 1.342 (95% CI, 1.157-1.557) for 1, 2, and 3 positive FIT results, respectively, vs negative FIT results.

Study details: Findings are from a retrospective nationwide population-based study of 1,395,147 participants aged 50 years or above who underwent screening for colorectal cancer.

Disclosures: The study was supported by the New Faculty Startup Fund from Seoul National University. The authors declared no potential conflict of interests.

Source: Lee HJ et al. Dermatology. 2021 Sep 16. doi: 10.1159/000518625.

Key clinical point: Guselkumab positively affected both clinician- and patient-reported outcomes in patients with moderate-to-severe plaque psoriasis, irrespective of their history of psoriasis therapies.

Major finding: After 28 weeks, 56.8% of patients attained a Dermatology Life Quality Index (DLQI) score of 1 or less, with the mean DLQI score decreasing from 13.7 at baseline to 2.8 (95% confidence interval [CI], 2.3-3.2), and mean Psoriasis Area Severity Index (PASI) decreasing from 16.4 at baseline to 3.0 (95% CI, 2.3-3.6), with a 55.3% PASI 90 response rate. Most adverse events were mild or moderate.

Study details: The data come from PERSIST, an ongoing, prospective, real-life study that enrolled 303 patients aged 18 years or above with moderate-to-severe plaque psoriasis for 2 years or more who were prescribed guselkumab.

Disclosures: This study was supported by Janssen-Cilag GmbH (Germany). S Wegner, Y Personke, and M Gomez reported being employees of Janssen-Cilag, whereas the other authors declared serving as an advisor, speaker, or clinical trial participant or receiving grants from various companies including Janssen-Cilag.

Source: Gerdes S et al. J Dermatol. 2021 Sep 12. doi: 10.1111/1346-8138.16128.

Key clinical point: Guselkumab positively affected both clinician- and patient-reported outcomes in patients with moderate-to-severe plaque psoriasis, irrespective of their history of psoriasis therapies.

Major finding: After 28 weeks, 56.8% of patients attained a Dermatology Life Quality Index (DLQI) score of 1 or less, with the mean DLQI score decreasing from 13.7 at baseline to 2.8 (95% confidence interval [CI], 2.3-3.2), and mean Psoriasis Area Severity Index (PASI) decreasing from 16.4 at baseline to 3.0 (95% CI, 2.3-3.6), with a 55.3% PASI 90 response rate. Most adverse events were mild or moderate.

Study details: The data come from PERSIST, an ongoing, prospective, real-life study that enrolled 303 patients aged 18 years or above with moderate-to-severe plaque psoriasis for 2 years or more who were prescribed guselkumab.

Disclosures: This study was supported by Janssen-Cilag GmbH (Germany). S Wegner, Y Personke, and M Gomez reported being employees of Janssen-Cilag, whereas the other authors declared serving as an advisor, speaker, or clinical trial participant or receiving grants from various companies including Janssen-Cilag.

Source: Gerdes S et al. J Dermatol. 2021 Sep 12. doi: 10.1111/1346-8138.16128.

Key clinical point: Guselkumab positively affected both clinician- and patient-reported outcomes in patients with moderate-to-severe plaque psoriasis, irrespective of their history of psoriasis therapies.

Major finding: After 28 weeks, 56.8% of patients attained a Dermatology Life Quality Index (DLQI) score of 1 or less, with the mean DLQI score decreasing from 13.7 at baseline to 2.8 (95% confidence interval [CI], 2.3-3.2), and mean Psoriasis Area Severity Index (PASI) decreasing from 16.4 at baseline to 3.0 (95% CI, 2.3-3.6), with a 55.3% PASI 90 response rate. Most adverse events were mild or moderate.

Study details: The data come from PERSIST, an ongoing, prospective, real-life study that enrolled 303 patients aged 18 years or above with moderate-to-severe plaque psoriasis for 2 years or more who were prescribed guselkumab.

Disclosures: This study was supported by Janssen-Cilag GmbH (Germany). S Wegner, Y Personke, and M Gomez reported being employees of Janssen-Cilag, whereas the other authors declared serving as an advisor, speaker, or clinical trial participant or receiving grants from various companies including Janssen-Cilag.

Source: Gerdes S et al. J Dermatol. 2021 Sep 12. doi: 10.1111/1346-8138.16128.

Key clinical point: Periodontitis serves as an independent risk factor for psoriasis and in combination with smoking synergistically contributes to psoriasis development.

Major finding: The risk for psoriasis was higher in patients with vs. without periodontitis (adjusted hazard ratio [aHR], 1.116; 95% confidence interval [CI], 1.101-1.13). Compared with nonsmokers without periodontitis, the risk for psoriasis in nonsmokers with periodontitis and smokers with periodontitis increased by 11% (aHR, 1.11; 95% CI, 1.094-1.127) and 26.5% (aHR, 1.265; 95% CI, 1.234-1.296), respectively.

Study details: The data come from a 9-year follow-up, nationwide, population-based cohort study that included 1,063,004 and 8,655,587 patients with and without periodontitis, respectively, and not pre-diagnosed with psoriasis.

Disclosures: The study was supported by a National Research Foundation of Korea grant funded by the Korean government. The authors declared no potential conflict of interests.

Source: Han JH et al. Dermatology. 2021 Sep 15. doi: 10.1159/000518296.

Key clinical point: Periodontitis serves as an independent risk factor for psoriasis and in combination with smoking synergistically contributes to psoriasis development.

Major finding: The risk for psoriasis was higher in patients with vs. without periodontitis (adjusted hazard ratio [aHR], 1.116; 95% confidence interval [CI], 1.101-1.13). Compared with nonsmokers without periodontitis, the risk for psoriasis in nonsmokers with periodontitis and smokers with periodontitis increased by 11% (aHR, 1.11; 95% CI, 1.094-1.127) and 26.5% (aHR, 1.265; 95% CI, 1.234-1.296), respectively.

Study details: The data come from a 9-year follow-up, nationwide, population-based cohort study that included 1,063,004 and 8,655,587 patients with and without periodontitis, respectively, and not pre-diagnosed with psoriasis.

Disclosures: The study was supported by a National Research Foundation of Korea grant funded by the Korean government. The authors declared no potential conflict of interests.

Source: Han JH et al. Dermatology. 2021 Sep 15. doi: 10.1159/000518296.

Key clinical point: Periodontitis serves as an independent risk factor for psoriasis and in combination with smoking synergistically contributes to psoriasis development.

Major finding: The risk for psoriasis was higher in patients with vs. without periodontitis (adjusted hazard ratio [aHR], 1.116; 95% confidence interval [CI], 1.101-1.13). Compared with nonsmokers without periodontitis, the risk for psoriasis in nonsmokers with periodontitis and smokers with periodontitis increased by 11% (aHR, 1.11; 95% CI, 1.094-1.127) and 26.5% (aHR, 1.265; 95% CI, 1.234-1.296), respectively.

Study details: The data come from a 9-year follow-up, nationwide, population-based cohort study that included 1,063,004 and 8,655,587 patients with and without periodontitis, respectively, and not pre-diagnosed with psoriasis.

Disclosures: The study was supported by a National Research Foundation of Korea grant funded by the Korean government. The authors declared no potential conflict of interests.

Source: Han JH et al. Dermatology. 2021 Sep 15. doi: 10.1159/000518296.

Key clinical point: Proactive management with calcipotriene 50 μg/g and betamethasone dipropionate 0.5 mg/g (Cal/BD) foam vs. reactive management with vehicle foam decreased the severity of patient-reported symptoms in patients with plaque psoriasis.

Major finding: Proactive vs. reactive management during 52-week maintenance showed greater improvement in Psoriasis Symptom Inventory (difference, −0.75; P = .0128) and Dermatology Life Quality Index (difference −0.45; P = .007) and nonsignificantly higher EuroQol-5D for psoriasis (0.89 vs 0.88; P = .0842) scores.

Study details: Findings are from a post hoc analysis of phase 3 PSO-LONG trial including 521 patients with plaque psoriasis randomly assigned to proactive management (Cal/BD foam twice weekly) or reactive management (vehicle foam twice weekly) arms.

Disclosures: The study was sponsored by Leo Pharma. The authors declared serving as consultants, advisory board members, and clinical trial investigators or receiving grants/speaker honoraria from various sources, including LEO Pharma.

Source: Jalili A et al. J Eur Acad Dermatol Venereol. 2021 Sep 20. doi: 10.1111/jdv.17673.

Key clinical point: Proactive management with calcipotriene 50 μg/g and betamethasone dipropionate 0.5 mg/g (Cal/BD) foam vs. reactive management with vehicle foam decreased the severity of patient-reported symptoms in patients with plaque psoriasis.

Major finding: Proactive vs. reactive management during 52-week maintenance showed greater improvement in Psoriasis Symptom Inventory (difference, −0.75; P = .0128) and Dermatology Life Quality Index (difference −0.45; P = .007) and nonsignificantly higher EuroQol-5D for psoriasis (0.89 vs 0.88; P = .0842) scores.

Study details: Findings are from a post hoc analysis of phase 3 PSO-LONG trial including 521 patients with plaque psoriasis randomly assigned to proactive management (Cal/BD foam twice weekly) or reactive management (vehicle foam twice weekly) arms.

Disclosures: The study was sponsored by Leo Pharma. The authors declared serving as consultants, advisory board members, and clinical trial investigators or receiving grants/speaker honoraria from various sources, including LEO Pharma.

Source: Jalili A et al. J Eur Acad Dermatol Venereol. 2021 Sep 20. doi: 10.1111/jdv.17673.

Key clinical point: Proactive management with calcipotriene 50 μg/g and betamethasone dipropionate 0.5 mg/g (Cal/BD) foam vs. reactive management with vehicle foam decreased the severity of patient-reported symptoms in patients with plaque psoriasis.

Major finding: Proactive vs. reactive management during 52-week maintenance showed greater improvement in Psoriasis Symptom Inventory (difference, −0.75; P = .0128) and Dermatology Life Quality Index (difference −0.45; P = .007) and nonsignificantly higher EuroQol-5D for psoriasis (0.89 vs 0.88; P = .0842) scores.

Study details: Findings are from a post hoc analysis of phase 3 PSO-LONG trial including 521 patients with plaque psoriasis randomly assigned to proactive management (Cal/BD foam twice weekly) or reactive management (vehicle foam twice weekly) arms.

Disclosures: The study was sponsored by Leo Pharma. The authors declared serving as consultants, advisory board members, and clinical trial investigators or receiving grants/speaker honoraria from various sources, including LEO Pharma.

Source: Jalili A et al. J Eur Acad Dermatol Venereol. 2021 Sep 20. doi: 10.1111/jdv.17673.

Key clinical point: The disease severity assessment, guiding initiation of systemic therapy, differed when either patient- or clinician-reported outcomes were considered alone, highlighting the complementary value of both for appropriate treatment.

Major finding: Overall, 72.4% (95% confidence interval [CI], 67.3%-77.0%) of patients who qualified for systemic therapy initiation on account of Psoriasis Area Severity Index (PASI) scores or body surface area (BSA) of 10 or higher had a Dermatology Life Quality Index (DLQI) score of less than 10. Conversely, 10.4% (95% CI, 8.8%-12.1%) of patients with a DLQI score higher than 10 did not qualify for systemic therapy based on PASI scores or BSA.

Study details: Findings are from a cross-sectional, observational study including 1,733 patients with mild, moderate, or severe psoriasis who met the criteria for initiation of systemic therapy based on DLQI score, PASI score, or BSA.

Disclosures: No specific funding for the study was disclosed. Dr. Gelfand declared receiving consultation fees and research grants from various sources.

Source: Barbieri JS et al. JAMA Dermatol. 2021 Sep 8. doi: 10.1001/jamadermatol.2021.3341.

Key clinical point: The disease severity assessment, guiding initiation of systemic therapy, differed when either patient- or clinician-reported outcomes were considered alone, highlighting the complementary value of both for appropriate treatment.

Major finding: Overall, 72.4% (95% confidence interval [CI], 67.3%-77.0%) of patients who qualified for systemic therapy initiation on account of Psoriasis Area Severity Index (PASI) scores or body surface area (BSA) of 10 or higher had a Dermatology Life Quality Index (DLQI) score of less than 10. Conversely, 10.4% (95% CI, 8.8%-12.1%) of patients with a DLQI score higher than 10 did not qualify for systemic therapy based on PASI scores or BSA.

Study details: Findings are from a cross-sectional, observational study including 1,733 patients with mild, moderate, or severe psoriasis who met the criteria for initiation of systemic therapy based on DLQI score, PASI score, or BSA.

Disclosures: No specific funding for the study was disclosed. Dr. Gelfand declared receiving consultation fees and research grants from various sources.

Source: Barbieri JS et al. JAMA Dermatol. 2021 Sep 8. doi: 10.1001/jamadermatol.2021.3341.

Key clinical point: The disease severity assessment, guiding initiation of systemic therapy, differed when either patient- or clinician-reported outcomes were considered alone, highlighting the complementary value of both for appropriate treatment.

Major finding: Overall, 72.4% (95% confidence interval [CI], 67.3%-77.0%) of patients who qualified for systemic therapy initiation on account of Psoriasis Area Severity Index (PASI) scores or body surface area (BSA) of 10 or higher had a Dermatology Life Quality Index (DLQI) score of less than 10. Conversely, 10.4% (95% CI, 8.8%-12.1%) of patients with a DLQI score higher than 10 did not qualify for systemic therapy based on PASI scores or BSA.

Study details: Findings are from a cross-sectional, observational study including 1,733 patients with mild, moderate, or severe psoriasis who met the criteria for initiation of systemic therapy based on DLQI score, PASI score, or BSA.

Disclosures: No specific funding for the study was disclosed. Dr. Gelfand declared receiving consultation fees and research grants from various sources.

Source: Barbieri JS et al. JAMA Dermatol. 2021 Sep 8. doi: 10.1001/jamadermatol.2021.3341.

Key clinical point: Risankizumab displayed superior long-term clinical efficacy against moderate-to-severe psoriasis, with no new safety signals in the 52-week update of a multicenter real-life study.

Major finding: Psoriasis Area and Severity Index (PASI) 75, PASI 90, and PASI 100 response rates at week 36 were 92.7%, 83.6%, and 65.5%, which were maintained through week 52 at 96.4%, 85.5%, and 60.0%, respectively. Unlike in phase 3 trials, more biologic-experienced patients reached PASI 100 at weeks 36 and 52 (71.8% and 69.2%, respectively) compared with biologic-naïve patients (50.0% and 37.5%, respectively).

Study details: Findings are from a real-life multicenter study including 57 adult patients with moderate-to-severe psoriasis who were receiving risankizumab therapy.

Disclosures: The study did not receive any funding. Some of the authors including the lead author declared receiving consultation/personal fees or research grants from various sources.

Source: Hansel K et al. J Eur Acad Dermatol Venereol. 2021 Sep 12. doi: 10.1111/jdv.17656.

Key clinical point: Risankizumab displayed superior long-term clinical efficacy against moderate-to-severe psoriasis, with no new safety signals in the 52-week update of a multicenter real-life study.

Major finding: Psoriasis Area and Severity Index (PASI) 75, PASI 90, and PASI 100 response rates at week 36 were 92.7%, 83.6%, and 65.5%, which were maintained through week 52 at 96.4%, 85.5%, and 60.0%, respectively. Unlike in phase 3 trials, more biologic-experienced patients reached PASI 100 at weeks 36 and 52 (71.8% and 69.2%, respectively) compared with biologic-naïve patients (50.0% and 37.5%, respectively).

Study details: Findings are from a real-life multicenter study including 57 adult patients with moderate-to-severe psoriasis who were receiving risankizumab therapy.

Disclosures: The study did not receive any funding. Some of the authors including the lead author declared receiving consultation/personal fees or research grants from various sources.

Source: Hansel K et al. J Eur Acad Dermatol Venereol. 2021 Sep 12. doi: 10.1111/jdv.17656.

Key clinical point: Risankizumab displayed superior long-term clinical efficacy against moderate-to-severe psoriasis, with no new safety signals in the 52-week update of a multicenter real-life study.

Major finding: Psoriasis Area and Severity Index (PASI) 75, PASI 90, and PASI 100 response rates at week 36 were 92.7%, 83.6%, and 65.5%, which were maintained through week 52 at 96.4%, 85.5%, and 60.0%, respectively. Unlike in phase 3 trials, more biologic-experienced patients reached PASI 100 at weeks 36 and 52 (71.8% and 69.2%, respectively) compared with biologic-naïve patients (50.0% and 37.5%, respectively).

Study details: Findings are from a real-life multicenter study including 57 adult patients with moderate-to-severe psoriasis who were receiving risankizumab therapy.

Disclosures: The study did not receive any funding. Some of the authors including the lead author declared receiving consultation/personal fees or research grants from various sources.

Source: Hansel K et al. J Eur Acad Dermatol Venereol. 2021 Sep 12. doi: 10.1111/jdv.17656.

Key clinical point: Secukinumab demonstrated a high skin-clearing effect and favorable safety in pediatric patients with moderate-to-severe plaque psoriasis through week 24.

Major finding: At week 12, low dose (LD) and high dose (HD) groups showed a Psoriasis Area Severity Index (PASI) 75 response rate (RR) of 92.9%, whereas their Investigator's Global Assessment (IGA) 0/1 RRs were 78.5% and 83.4%, respectively. At week 24, the PASI 75 RR for LD and HD groups increased to 95.2% and IGA 0/1 RRs increased to 88.1% and 92.9%, respectively. Both groups displayed similar treatment-emergent adverse events.

Study details: These are 24-week findings of a 224-week, open-label, phase 3 study including 84 pediatric patients with moderate-to-severe plaque psoriasis randomly assigned to LD or HD secukinumab (75/75/150 or 75/150/300 mg for body weight (kg) less than 25/25 to less than 50/50 or more, respectively).

Disclosures: The study was sponsored by Novartis Pharma AG, Switzerland. R Mazur, P Forrer, and M Patekar declared being employees of Novartis Pharma AG. Some of the authors declared serving on advisory board, speaker, consultant, or principal/subinvestigator for various organizations including Novartis.

Source: Magnolo N et al. J Am Acad Dermatol. 2021 Sep 20. doi: 10.1016/j.jaad.2021.08.066.

Key clinical point: Secukinumab demonstrated a high skin-clearing effect and favorable safety in pediatric patients with moderate-to-severe plaque psoriasis through week 24.

Major finding: At week 12, low dose (LD) and high dose (HD) groups showed a Psoriasis Area Severity Index (PASI) 75 response rate (RR) of 92.9%, whereas their Investigator's Global Assessment (IGA) 0/1 RRs were 78.5% and 83.4%, respectively. At week 24, the PASI 75 RR for LD and HD groups increased to 95.2% and IGA 0/1 RRs increased to 88.1% and 92.9%, respectively. Both groups displayed similar treatment-emergent adverse events.

Study details: These are 24-week findings of a 224-week, open-label, phase 3 study including 84 pediatric patients with moderate-to-severe plaque psoriasis randomly assigned to LD or HD secukinumab (75/75/150 or 75/150/300 mg for body weight (kg) less than 25/25 to less than 50/50 or more, respectively).

Disclosures: The study was sponsored by Novartis Pharma AG, Switzerland. R Mazur, P Forrer, and M Patekar declared being employees of Novartis Pharma AG. Some of the authors declared serving on advisory board, speaker, consultant, or principal/subinvestigator for various organizations including Novartis.

Source: Magnolo N et al. J Am Acad Dermatol. 2021 Sep 20. doi: 10.1016/j.jaad.2021.08.066.

Key clinical point: Secukinumab demonstrated a high skin-clearing effect and favorable safety in pediatric patients with moderate-to-severe plaque psoriasis through week 24.

Major finding: At week 12, low dose (LD) and high dose (HD) groups showed a Psoriasis Area Severity Index (PASI) 75 response rate (RR) of 92.9%, whereas their Investigator's Global Assessment (IGA) 0/1 RRs were 78.5% and 83.4%, respectively. At week 24, the PASI 75 RR for LD and HD groups increased to 95.2% and IGA 0/1 RRs increased to 88.1% and 92.9%, respectively. Both groups displayed similar treatment-emergent adverse events.

Study details: These are 24-week findings of a 224-week, open-label, phase 3 study including 84 pediatric patients with moderate-to-severe plaque psoriasis randomly assigned to LD or HD secukinumab (75/75/150 or 75/150/300 mg for body weight (kg) less than 25/25 to less than 50/50 or more, respectively).

Disclosures: The study was sponsored by Novartis Pharma AG, Switzerland. R Mazur, P Forrer, and M Patekar declared being employees of Novartis Pharma AG. Some of the authors declared serving on advisory board, speaker, consultant, or principal/subinvestigator for various organizations including Novartis.

Source: Magnolo N et al. J Am Acad Dermatol. 2021 Sep 20. doi: 10.1016/j.jaad.2021.08.066.

A new study has found that patients with psoriasis who were treated with biologics were more likely to develop psoriatic arthritis (PsA) than those treated with phototherapy, oral therapy, or no therapy at all, although the authors cautioned readers to consider potential biases when reviewing their findings.

“We do not suggest that these results should be interpreted causally; in other words, biologics likely do not cause PsA,” Elana Meer of the University of Pennsylvania, Philadelphia, and coauthors wrote. The study was published in Annals of the Rheumatic Diseases.

Three studies in dermatology clinic-based populations published this past summer – one from Italy, one from Argentina, and one from Israel – suggested that biologics can decrease a psoriasis patient’s risk of developing PsA. To further assess the impact of treatment with biologics, Ms. Meer and associates retrospectively examined the health records of thousands of patients with psoriasis between the ages of 16 and 90 who were initiating therapy. All told, data from 193,709 patients with psoriasis and without PsA who were treated between 2006 and 2017 were gathered from the OptumInsights Electronic Health Record Database.

A total of 14,569 patients from that cohort initiated biologic therapy while 20,321 patients initiated either oral therapy or phototherapy. The mean age in the biologics group was 45.9 years, compared with 49.8 years in the oral and phototherapy group.

The incidence of PsA across all patients was 9.75 cases per 1,000 person-years, compared with 77.26 among the biologic group, 61.99 among the oral therapy group, 26.11 among the phototherapy group, and 5.85 among those who did not receive therapy. After a multivariable adjustment in which biologics were a time-varying exposure, receiving biologics was associated with a higher incidence of PsA (hazard ratio, 4.48; 95% confidence interval, 4.23-4.75). In a model where time starts at the first use of biologics, the incidence was lower – but still notable – after multivariable adjustment (HR, 2.14; 95% CI, 2.00-2.28) and propensity score matching (HR, 2.17; 95% CI, 2.03-2.33).

Bias likely plays a large role in retrospective PsA study

“We’ve been struggling for the last several years to find a database that allows us to really address this question retrospectively,” study coauthor Christopher T. Ritchlin, MD, of the University of Rochester (N.Y.), said in an interview. “It looks like the model you use for a retrospective analysis heavily influences what you come out with.”

He described the potential biases they identified, including the possibility of protopathic bias indicating that patients being treated with biologics who then report joint pain have developed PsA – and are coded accordingly after visiting a rheumatologist.

“This has convinced us that you have to do a prospective study,” he said. “We’ve known that there were flaws with previous studies in this area. We tried to overcome them with our methodology, but there’s no way you can overcome a coding issue when you’re looking at such a large database.”

He noted another likely bias: The patients who are more likely to develop PsA are the ones with severe psoriasis, and they are also the patients most likely to be prescribed biologics.

Courtesy Dr. Joel M. Gelfand

“In my clinical experience, I have seen many patients develop psoriatic arthritis while on biologics for their psoriasis,” coauthor Joel M. Gelfand, MD, of the University of Pennsylvania, added in an interview. “Currently, we do not have adequate data to recommend treating psoriasis with a particular modality in order to prevent psoriatic arthritis. This question, however, is very important to patients and clinicians and ultimately is best answered with a large-scale pragmatic trial.”

Dr. Ritchlin reported that a prospective study in which “patients with psoriasis who do not have arthritis but do have certain risk factors and abnormal findings on musculoskeletal ultrasounds” will be treated with either biologic agents or placebo is about to begin, with a goal of “either attenuating or preventing the onset of PsA.”

The authors recognized their study’s additional limitations, including electronic health records being used as the primary data source and the possibility that medications were prescribed but never filled. That said, they did attempt to address the latter by using two prescriptions for a given therapy as the primary analysis, “suggesting a refill was initiated.”

The authors said that no commercial entities provided support for the study. Two of the authors acknowledged receiving funding from the National Psoriasis Foundation, and several authors declared potential conflicts of interests that included consulting and receiving honoraria from various pharmaceutical companies.

A new study has found that patients with psoriasis who were treated with biologics were more likely to develop psoriatic arthritis (PsA) than those treated with phototherapy, oral therapy, or no therapy at all, although the authors cautioned readers to consider potential biases when reviewing their findings.

“We do not suggest that these results should be interpreted causally; in other words, biologics likely do not cause PsA,” Elana Meer of the University of Pennsylvania, Philadelphia, and coauthors wrote. The study was published in Annals of the Rheumatic Diseases.

Three studies in dermatology clinic-based populations published this past summer – one from Italy, one from Argentina, and one from Israel – suggested that biologics can decrease a psoriasis patient’s risk of developing PsA. To further assess the impact of treatment with biologics, Ms. Meer and associates retrospectively examined the health records of thousands of patients with psoriasis between the ages of 16 and 90 who were initiating therapy. All told, data from 193,709 patients with psoriasis and without PsA who were treated between 2006 and 2017 were gathered from the OptumInsights Electronic Health Record Database.

A total of 14,569 patients from that cohort initiated biologic therapy while 20,321 patients initiated either oral therapy or phototherapy. The mean age in the biologics group was 45.9 years, compared with 49.8 years in the oral and phototherapy group.

The incidence of PsA across all patients was 9.75 cases per 1,000 person-years, compared with 77.26 among the biologic group, 61.99 among the oral therapy group, 26.11 among the phototherapy group, and 5.85 among those who did not receive therapy. After a multivariable adjustment in which biologics were a time-varying exposure, receiving biologics was associated with a higher incidence of PsA (hazard ratio, 4.48; 95% confidence interval, 4.23-4.75). In a model where time starts at the first use of biologics, the incidence was lower – but still notable – after multivariable adjustment (HR, 2.14; 95% CI, 2.00-2.28) and propensity score matching (HR, 2.17; 95% CI, 2.03-2.33).

Bias likely plays a large role in retrospective PsA study

“We’ve been struggling for the last several years to find a database that allows us to really address this question retrospectively,” study coauthor Christopher T. Ritchlin, MD, of the University of Rochester (N.Y.), said in an interview. “It looks like the model you use for a retrospective analysis heavily influences what you come out with.”

He described the potential biases they identified, including the possibility of protopathic bias indicating that patients being treated with biologics who then report joint pain have developed PsA – and are coded accordingly after visiting a rheumatologist.

“This has convinced us that you have to do a prospective study,” he said. “We’ve known that there were flaws with previous studies in this area. We tried to overcome them with our methodology, but there’s no way you can overcome a coding issue when you’re looking at such a large database.”

He noted another likely bias: The patients who are more likely to develop PsA are the ones with severe psoriasis, and they are also the patients most likely to be prescribed biologics.

Courtesy Dr. Joel M. Gelfand

“In my clinical experience, I have seen many patients develop psoriatic arthritis while on biologics for their psoriasis,” coauthor Joel M. Gelfand, MD, of the University of Pennsylvania, added in an interview. “Currently, we do not have adequate data to recommend treating psoriasis with a particular modality in order to prevent psoriatic arthritis. This question, however, is very important to patients and clinicians and ultimately is best answered with a large-scale pragmatic trial.”

Dr. Ritchlin reported that a prospective study in which “patients with psoriasis who do not have arthritis but do have certain risk factors and abnormal findings on musculoskeletal ultrasounds” will be treated with either biologic agents or placebo is about to begin, with a goal of “either attenuating or preventing the onset of PsA.”

The authors recognized their study’s additional limitations, including electronic health records being used as the primary data source and the possibility that medications were prescribed but never filled. That said, they did attempt to address the latter by using two prescriptions for a given therapy as the primary analysis, “suggesting a refill was initiated.”

The authors said that no commercial entities provided support for the study. Two of the authors acknowledged receiving funding from the National Psoriasis Foundation, and several authors declared potential conflicts of interests that included consulting and receiving honoraria from various pharmaceutical companies.

A new study has found that patients with psoriasis who were treated with biologics were more likely to develop psoriatic arthritis (PsA) than those treated with phototherapy, oral therapy, or no therapy at all, although the authors cautioned readers to consider potential biases when reviewing their findings.

“We do not suggest that these results should be interpreted causally; in other words, biologics likely do not cause PsA,” Elana Meer of the University of Pennsylvania, Philadelphia, and coauthors wrote. The study was published in Annals of the Rheumatic Diseases.

Three studies in dermatology clinic-based populations published this past summer – one from Italy, one from Argentina, and one from Israel – suggested that biologics can decrease a psoriasis patient’s risk of developing PsA. To further assess the impact of treatment with biologics, Ms. Meer and associates retrospectively examined the health records of thousands of patients with psoriasis between the ages of 16 and 90 who were initiating therapy. All told, data from 193,709 patients with psoriasis and without PsA who were treated between 2006 and 2017 were gathered from the OptumInsights Electronic Health Record Database.

A total of 14,569 patients from that cohort initiated biologic therapy while 20,321 patients initiated either oral therapy or phototherapy. The mean age in the biologics group was 45.9 years, compared with 49.8 years in the oral and phototherapy group.

The incidence of PsA across all patients was 9.75 cases per 1,000 person-years, compared with 77.26 among the biologic group, 61.99 among the oral therapy group, 26.11 among the phototherapy group, and 5.85 among those who did not receive therapy. After a multivariable adjustment in which biologics were a time-varying exposure, receiving biologics was associated with a higher incidence of PsA (hazard ratio, 4.48; 95% confidence interval, 4.23-4.75). In a model where time starts at the first use of biologics, the incidence was lower – but still notable – after multivariable adjustment (HR, 2.14; 95% CI, 2.00-2.28) and propensity score matching (HR, 2.17; 95% CI, 2.03-2.33).

Bias likely plays a large role in retrospective PsA study

“We’ve been struggling for the last several years to find a database that allows us to really address this question retrospectively,” study coauthor Christopher T. Ritchlin, MD, of the University of Rochester (N.Y.), said in an interview. “It looks like the model you use for a retrospective analysis heavily influences what you come out with.”

He described the potential biases they identified, including the possibility of protopathic bias indicating that patients being treated with biologics who then report joint pain have developed PsA – and are coded accordingly after visiting a rheumatologist.

“This has convinced us that you have to do a prospective study,” he said. “We’ve known that there were flaws with previous studies in this area. We tried to overcome them with our methodology, but there’s no way you can overcome a coding issue when you’re looking at such a large database.”

He noted another likely bias: The patients who are more likely to develop PsA are the ones with severe psoriasis, and they are also the patients most likely to be prescribed biologics.

Courtesy Dr. Joel M. Gelfand

“In my clinical experience, I have seen many patients develop psoriatic arthritis while on biologics for their psoriasis,” coauthor Joel M. Gelfand, MD, of the University of Pennsylvania, added in an interview. “Currently, we do not have adequate data to recommend treating psoriasis with a particular modality in order to prevent psoriatic arthritis. This question, however, is very important to patients and clinicians and ultimately is best answered with a large-scale pragmatic trial.”

Dr. Ritchlin reported that a prospective study in which “patients with psoriasis who do not have arthritis but do have certain risk factors and abnormal findings on musculoskeletal ultrasounds” will be treated with either biologic agents or placebo is about to begin, with a goal of “either attenuating or preventing the onset of PsA.”

The authors recognized their study’s additional limitations, including electronic health records being used as the primary data source and the possibility that medications were prescribed but never filled. That said, they did attempt to address the latter by using two prescriptions for a given therapy as the primary analysis, “suggesting a refill was initiated.”

The authors said that no commercial entities provided support for the study. Two of the authors acknowledged receiving funding from the National Psoriasis Foundation, and several authors declared potential conflicts of interests that included consulting and receiving honoraria from various pharmaceutical companies.