'Tough-to-treat psoriasis remains a challenge despite newer therapies ... Why do we still have this sub-population of patients who seem to be refractory?'
Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit.may have several causes, from genetic endotypes and immunologic factors to lower serum drug levels, the presence of anti-drug antibody levels, female sex, and certain comorbidities, Wilson Liao, MD, said at the annual research symposium of the National Psoriasis Foundation.
Of 1,039 evaluated patients, 490 had good clinical response to their first biologic and 65 had multiple biologic failure. All biologic classes were represented among those who failed multiple biologics. The first and second biologic classes used were attempted for a mean duration of 10 months –"an adequate trial" of each, Dr. Liao said.
The option of focusing on comorbidities in the face of biologic failure was another point of discussion."Maybe the next biologic is not the answer," a meeting participant said."Maybe we should focus on metabolic syndrome." The French study covered almost 3,000 patients who started a second biologic after discontinuing a TNF inhibitor during 2015-2020. Overall, 1-year and 3-year persistence rates were 42% and 17%, respectively.
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