279 Proportions of biologic discontinuation among psoriasis patients with metabolic comorbidities

Abstract

Background: The purpose of the study was to analyze the proportions of biologic discontinuation among psoriasis patients with and without metabolic comorbidities, and stratified by drug class, using real-world data. Methods: The Corrona® Psoriasis Registry is a prospective, multicenter, non-interventional registry in North America. Patients with plaque psoriasis who initiated a biologic therapy (5/2015 to 12/2019) and had a 6-month follow-up visit were included (N=2,924). The proportion of biologic discontinuations by 6 months post-initiation were calculated by metabolic comorbid status (current obesity and histories of hypertension [HTN], diabetes [DM], and hyperlipidemia [HLD]) and by drug class (tumor necrosis factor [TNF] inhibitors, interleukin [IL]-17 inhibitors, IL-23 or IL-12/23 inhibitors). Results: Higher frequencies of patients with obesity (17% vs. 13%) and with DM history (20% vs. 14%) discontinued compared to those without, while discontinuations were similar between those with and without HTN and HLD history. Patients initiating TNFs had higher proportions of discontinuation than the IL-17 and IL-23/IL-12/23 groups. Among patients initiating TNFs, those with obesity, DM history and HTN history had higher proportions of discontinuation (30%, 34%, 34%, respectively) vs. those without (22%, 24%, 22%, respectively), while among IL-23 or IL-12/23 initiators, compared to patients without, patients with obesity (11% vs. 7%) or DM history (13% vs. 8%) had slightly higher proportions of discontinuations. Discontinuations did not differ between obesity or comorbidity groups in IL-17 initiators. Conclusion: In these real-world psoriasis patients, those with obesity and history of DM had higher proportions of biologic discontinuations 6 months following initiation, except in the IL-17 class. Metabolic comorbidities should be considered when choosing biologics.