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Background : Psoriasis is a skin disease characterized by the presence of erythematous, scaly plaques on the extensor surfaces of the body. Treatment varies according to the stage of the disease, with the most severe cases being treated with biologic treatments that differ in efficacy and persistence over time. This study aimed to evaluate the 10-year persistence of biologic drugs (adalimumab, etanercept, infliximab and ustekinumab) in the treatment of moderate-to-severe plaque psoriasis. Methods : A total of 143 patients (61 women and 82 men) were evaluated; data were collected from the electronic clinical history, and statistical analysis was performed using the SPSS program. In addition, 115 of them were genotyped in a previous study for 173 immune system genetic polymorphisms. Results : The persistence of biologic drugs at 10 years was 25.9% (95% CI: 17.2-34.5%). Adalimumab was the most persistent drug (41.5%), followed by ustekinumab (34.8%), infliximab (28%) and etanercept (9.3%). The main reason for discontinuation was insufficient efficacy (51%). Adalimumab allowed an increase in the dosing interval in 82.4% of patients who persisted and ustekinumab allowed an increase in 37.5%. The 10-year persistence was related to sex (higher in men, p < 0.001), biologic drug ( p = 0.002) and polymorphisms in LMO4 (rs983332) ( p = 0.014) and IL20RA (rs1167846) ( p = 0.013). Conclusion : The results show that 25% of psoriasis patients treated with first-line biologics persisted at 10 years.

Background: Tildrakizumab is a humanized, IgG1/κ antibody that interacts with the p19 subunit of interleukin 23. It is approved for the treatment of moderate-to-severe plaque psoriasis. Real-world evidence on the effectiveness and safety of tildrakizumab is limited., Objectives: To assess the effectiveness and safety of tildrakizumab at 24 weeks in patients with moderate-to-severe plaque psoriasis in routine clinical practice., Methods: Retrospective, observational, multicentre study including adult patients with moderate-to-severe plaque psoriasis treated with tildrakizumab under real-life conditions. Patient data were extracted from anonymized electronic medical records. Statistical analysis was performed using SPSS22., Results: A total of 190 patients were included. About 53.9% were men with a mean age of 51.45 (SD 3.9) and a mean BMI of 29.13 (SD 6.21). About 79.8% (132 out of 190) of patients had previously received biological therapy (BT) and 17.3% (33 out of 191) had psoriatic arthritis. Baseline PASI was 10.7 (SD 6.53). Up to 109 patients reached Week 24 and at this point mean baseline PASI decreased to 1.7 (SD 4.8), representing an 88.79% mean PASI reduction. At 6 months, 87.1% and 40.3% of the treated patients achieved PASI ≤3 and ≤1, respectively. At Week 24 mean BSA decreased from 13.2 (SD 10.07) to 1.6 (SD 4.40) and mean DLQI went from 12.5 (SD 7.12) to 1.2 (SD 3.27). Multivariate analysis showed no differences when effectiveness was correlated with gender, obesity, psoriatic arthritis or prior exposure to BT. The rate of adverse events (AE) was 5.9% (11 out of 190), where infections were the most frequent AE (4 out of 11). One patient suffered a haemorrhagic ictus and one patient died due to causes unrelated to the study., Conclusion: Tildrakizumab was effective and safe in a large cohort of patients with moderate-to-severe plaque psoriasis treated in a routine clinical setting., (© 2023 European Academy of Dermatology and Venereology.)