Predictors of initiating biologics in the treatment of psoriasis.

Autor: Linnemann E; Bronx High School of Science, New York, NY, USA., Nielsen ML; Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark., Maul LV; Department of Dermatology, University Hospital Zurich, Zurich, Switzerland., Richter C; Department of Dermatology, University Hospital Zurich, Zurich, Switzerland., Dommann I; Department of Dermatology, University Hospital Zurich, Zurich, Switzerland., Zink A; Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany., Schlapbach C; Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Yawalkar N; Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Conrad C; Department of Dermatology, CHUV University Hospital and University of Lausanne (UNIL), Lausanne, Switzerland., Cozzio A; Cantonal Hospital St. Gallen, St. Gallen, Switzerland., Kündig T; Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.; Faculty of Medicine, University of Zürich, Zürich, Switzerland., Navarini A; Department of Dermatology, University Hospital Basel, Basel, Switzerland., Egeberg A; Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Maul JT; Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.; Faculty of Medicine, University of Zürich, Zürich, Switzerland.
Jazyk: angličtina
Zdroj: International journal of dermatology [Int J Dermatol] 2024 Aug 07. Date of Electronic Publication: 2024 Aug 07.
DOI: 10.1111/ijd.17409
Abstrakt: Background: Biologics are among the most effective therapies for psoriasis. However, many patients are only introduced to them at advanced stages of the disease course.
Objectives: Our 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.
Methods: Kaplan-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.
Results: Our 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).
Conclusions: Age 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.
(© 2024 the International Society of Dermatology.)
Databáze: MEDLINE
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