Predictors of initiating biologics in the treatment of psoriasis

Author:

Linnemann Emilia1,Nielsen Mia‐Louise2ORCID,Maul Lara Valeska3,Richter Clara3,Dommann Isabella3,Zink Alexander4,Schlapbach Christoph5,Yawalkar Nikhil5,Conrad Curdin6,Cozzio Antonio7,Kündig Thomas48,Navarini Alexander9,Egeberg Alexander210,Maul Julia‐Tatjana38

Affiliation:

1. Bronx High School of Science New York NY USA

2. Department of Dermatology Bispebjerg Hospital Copenhagen Denmark

3. Department of Dermatology University Hospital Zurich Zurich Switzerland

4. Department of Dermatology and Allergy Technical University of Munich Munich Germany

5. Department of Dermatology, Inselspital Bern University Hospital, University of Bern Bern Switzerland

6. Department of Dermatology CHUV University Hospital and University of Lausanne (UNIL) Lausanne Switzerland

7. Cantonal Hospital St. Gallen St. Gallen Switzerland

8. Faculty of Medicine University of Zürich Zürich Switzerland

9. Department of Dermatology University Hospital Basel Basel Switzerland

10. Department of Clinical Medicine University of Copenhagen Copenhagen Denmark

Abstract

AbstractBackgroundBiologics are among the most effective therapies for psoriasis. However, many patients are only introduced to them at advanced stages of the disease course.ObjectivesOur aim was to identify predictors of initiating biologic therapy in patients with psoriasis and compare patients initiating biologics early versus late in their disease course.MethodsKaplan–Meier curves visualized time to biologic initiation, while Cox regression models further explored variables as predictors of biologic initiation. Mann–Whitney U and chi‐squared tests compared patients who started biologics early with those who began biologics later in the disease course.ResultsOur primary analysis included 233 psoriasis patients. Cox regression showed that age at diagnosis (P = 0.007), general physical well‐being (P = 0.02), and nail psoriasis severity (P = 0.02) were significantly associated with time to biologic initiation. Our secondary analysis, the comparisons between patients starting biologics early versus later in the disease course, included a total of 378 patients. The median (interquartile range [IQR]) age at diagnosis was 34.5 (25.0–51.2) years for patients initiating biologics within 5 years, compared to 22.0 (15.0–32.8) years for patients initiating biologics later (P < 0.0001). The median (IQR) age at initiation was 37.0 (27.0–53.2) and 45.0 (36.0–55.0) years for patients initiating biologics earlier versus later than 5 years (P = 0.04).ConclusionsAge at diagnosis, general well‐being, and severity of nail psoriasis significantly predicted future initiation of biologic treatment. Patients initiating biologics early in their disease course were generally older at diagnosis but younger at the time of biologic initiation compared to patients initiating biologics later in their disease course.

Publisher

Wiley

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