Long-Term Registry Data for Psoriasis Biologics

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Biologics have revolutionized the treatment of psoriasis since their introduction in 2003. Many registry studies have been created for the biologic therapy of psoriasis, which collects long-term real-world data on biologic safety, efficacy, and drug survival. These data are beneficial because they are obtained in patients’ natural environments and better reflect real-world behavior compared to clinical trials, but suffer from nonresponse bias and confounding bias, and lack the control arms of randomized controlled trials. Biologics have fewer adverse events and better long-term safety and overall effectiveness compared to older systemic treatments. Biologics have better overall drug survival compared to older systemic treatments, which may partly be due to greater efficacy or preferable dosing schedules. Ustekinumab has better drug survival than tumor necrosis factor-α inhibitors and is least frequently associated with discontinuation due to loss of efficacy. Etanercept is associated with the greatest discontinuation, which may be due to an increased loss of efficacy and greater incidence of injection site reactions. Biologic efficacy can be measured using the Psoriasis Area and Severity Index (PASI) or Physician Global Assessment (PGA) scores. Using the PASI score, secukinumab has higher efficacy than ustekinumab, adalimumab, and etanercept. Registry data can be used in conjunction with randomized controlled trial data to understand the long-term safety, efficacy, adverse events, adherence, and drug survival of biologics, which can assist physicians and patients with decisions on psoriasis treatment.KeywordsPsoriasisRegistryBiologic therapyReal-world evidenceSafetyEfficacyDrug survival