Hadeler Edward, Kumar Sugandh, Yeroushalmi Samuel, Hong Julie, Wallace Elizabeth, Han George, Mosca Megan, Bartholomew Erin, Chung Mimi, Hakimi Marwa, Reddy Soumya, Scher Jose, Bhutani Tina, Gondo George, Armstrong April, Bell Stacie, Liao Wilson
Department of Dermatology, University of California, San Francisco, CA, USA.
Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
J Psoriasis Psoriatic Arthritis. 2023 Jan;8(1):11-18. doi: 10.1177/24755303221131259. Epub 2022 Oct 8.
Despite their impressive efficacy in phase 3 trials, biologic agents for psoriasis (PsO) may lose efficacy over time. The factors associated with loss of efficacy have yet to be fully elucidated.
We aimed to identify factors associated with PsO patients using multiple biologics in comparison to patients who used 1 biologic. We also reviewed the literature comparing the survival of different biologic agents for PsO.
We examined clinical data from 222 psoriasis patients at the University of California San Francisco, of whom 51 reported use of 3 or more biologics and of whom 171 reported use of only a single biologic agent at the time of enrollment into a research database from 2006-2020. We performed univariate and multivariate regression analysis to identify significant demographic features, clinical features, and co-morbidities associated with multi-biologic use. We performed a literature review of studies comparing psoriasis biologic survival at 1, 2, and 5 years and factors associated with single biologic failure.
In univariate analysis, duration of PsO, initial presentation of PsO on the gluteal cleft, erythrodermic psoriasis, and acne were associated with using 3 or more biologics. In multivariate analysis, duration of PsO, erythrodermic psoriasis, and acne remained significant. Our review of biologic survival revealed differences according to biologic class.
We identified novel factors associated with multi-biologic use in PsO. Further studies in this area are needed to achieve a precision medicine approach.
尽管生物制剂在银屑病（PsO）的3期试验中疗效显著，但随着时间推移可能会失去疗效。与疗效丧失相关的因素尚未完全阐明。
我们旨在确定与使用多种生物制剂的银屑病患者相比，使用单一生物制剂的患者相关的因素。我们还回顾了比较不同银屑病生物制剂生存率的文献。
我们检查了加利福尼亚大学旧金山分校222例银屑病患者的临床数据，其中51例报告使用了3种或更多生物制剂，171例报告在2006年至2020年纳入研究数据库时仅使用了单一生物制剂。我们进行了单变量和多变量回归分析，以确定与多种生物制剂使用相关的显著人口统计学特征、临床特征和合并症。我们对比较银屑病生物制剂1年、2年和5年生存率以及与单一生物制剂失效相关因素的研究进行了文献综述。
在单变量分析中,银屑病病程、银屑病最初出现在臀沟、红皮病型银屑病和痤疮与使用3种或更多生物制剂有关。在多变量分析中，银屑病病程、红皮病型银屑病和痤疮仍然显著。我们对生物制剂生存率的综述显示，不同生物制剂类别存在差异。
我们确定了与银屑病患者使用多种生物制剂相关的新因素。该领域需要进一步研究以实现精准医学方法。
