Abstract
Background and Objectives: Biological therapy is widely used for the treatment of severe psoriasis. The objective of this study was to evaluate the efficacy and safety of biological therapy for patients with severe psoriasis. Materials and Methods: A retrospective study of 79 patients with severe psoriasis, who have been treated with biological therapy between 2012 and 2018, was conducted. During this study, the following data were collected and evaluated: sex, age, body mass index (BMI), duration of illness, the results of treatment with biological therapy, concomitant therapy, Psoriasis Area and Severity Index (PASI) and adverse events. Results: In total, 74.7% (n = 59) of subjects were male. Their overall average age was 47.4 ± 11.4 (range: 18–73) years. Their baseline BMI was 27.6 ± 5.9, which increased to 29.6 ± 4.5 after 6 years of treatment. The mean duration of psoriasis was 25.7 ± 12.5 years. In total, 39.2% (n = 31) of subjects received infliximab, 36.7% (n = 29)—etanercept, 24.1% (n = 19)—ustekinumab. The treatment duration for infliximab, etanercept and ustekinumab was 201.6 ± 86.8, 156.2 ± 137.4 and 219.1 ± 95.7 weeks (p < 0.01), respectively. Overall, 65.8% (n = 52) of subjects were also on methotrexate; 30.8% (n = 16) of them discontinued it due to clinical improvement (31.3% (n = 5)), impaired liver function (31.3% (n = 5)), and intolerance (25% (n = 4)). Baseline PASI was 20.8 ± 8.8. PASI 50 was achieved by 96.2% (n = 76) of patients at week 11, PASI 75 by 86.1% (n = 68) at week 16, PASI 90 by 54.4% (n = 43) at week 35, and PASI 100 by 13.9% (n = 11) at week 33. The overall incidence rate of adverse events was 0.362 per patient year of follow-up. Conclusion: Biological therapy is an effective and safe treatment for patients with severe psoriasis.
Highlights
Psoriasis is a chronic inflammatory and autoimmune disease that causes thickened, scaly plaques on the skin
The aim of this study is to evaluate the demographic data of patients with severe psoriasis who were treated with biological therapy, including prescribed biologics, baseline Psoriasis Area and Severity Index (PASI), dermatological quality of life index (DLQI), body mass index (BMI), laboratory and instrumental examination results and their changes during the therapy, adverse effects, comorbidities and their treatment
The total mean duration of morbidity was 25.7 ± 12.5 years, and the longest mean duration of psoriasis morbidity was among patients treated with ustekinumab—3.5 ± 13.9 years
Summary
Psoriasis is a chronic inflammatory and autoimmune disease that causes thickened, scaly plaques on the skin. It generally affects about 1–3% of the population worldwide [1,2]. While mild forms can be managed by topical therapy, moderate to severe psoriasis typically requires phototherapy and (or) systemic therapy. The objective of this study was to evaluate the efficacy and safety of biological therapy for patients with severe psoriasis. The following data were collected and evaluated: sex, age, body mass index (BMI), duration of illness, the results of treatment with biological therapy, concomitant therapy, Psoriasis. Results: In total, 74.7% (n = 59) of subjects were male Their overall average age was 47.4 ± 11.4 (range: 18–73) years.
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