Poster Presentation Australasian Society for Dermatology Research 2022 Annual Scientific Meeting

Drug survival of biologics in Psoriasis: A retrospective cohort study of outcomes at two major tertiary hospitals (#18)

Samantha Ting 1 , Pablo Fernández-Peñas 1 2 , Patricia Lowe 1 3 , Annika Smith 2
  1. The University of Sydney, Camperdown, NSW, Australia
  2. Dermatology, Westmead Hospital, Sydney
  3. Dermatology, Royal Prince Alfred Hospital, Sydney

In recent years, the advent of biologic therapy has revolutionised the management of psoriasis. Compared to traditional systemic therapies, biologics have significantly improved clinical outcomes in terms of quality of life and objective skin clearance (1). Despite this, data pertaining to the local experience and outcomes has been lacking.  Drug survival, which refers to the time to treatment discontinuation, provides a gauge of the effectiveness of a biologic in a real-world setting (2). The aim of this study was to review drug survival of biologics in psoriasis across two Australian tertiary hospitals.

Retrospective data from outpatient Dermatology biologic clinics in Westmead Hospital and Royal Prince Alfred Hospital (Sydney, Australia) from April 2006 to December 2020 were collated. This data included baseline characteristics, treatment courses received and survival data. Biologics included were adalimumab, etanercept, infliximab, tildrakizumab, risankizumab, guselkumab, ustekinumab, secukinumab and ixekizumab. Drug survival data was analysed using Kaplan-Meier survival analysis.

In total, 340 patients underwent 602 treatment courses. Across all treatment courses (n=602), the 3-year survival was 56.2%. Guselkumab had the longest 3-year drug survival rate of 94.4% (n=37). This was followed by ixekizumab (65%, n=61) and ustekinumab (62%, n=151). In further analysis of biologic-naïve patients (n=298), guselkumab had the highest 1-year and 3-year drug survival rate of 100% (n=12). Among biologic-experienced patients (304 treatment courses), risankizumab (n=54) had the highest 1-year (92.9%) survival, and guselkumab (n=24) had the highest 3-year survival (91.3%).

This study demonstrates the effectiveness of various biologics in psoriasis across two major tertiary centres over a 15-year period. To our knowledge, this is the first study in Australia that has reported on drug survival that includes outcomes from IL-23 and IL-17 inhibitors. Overall, this data provides insight into patterns of care from a local experience that may help guide the management of moderate-to-severe psoriasis. 

  1. 1. Norlin JM, Steen Carlsson K, Persson U, Schmitt-Egenolf M. Switch to biological agent in psoriasis significantly improved clinical and patient-reported outcomes in real-world practice. Dermatology. 2012;225(4):326-32.
  2. 2. van den Reek J, Kievit W, Gniadecki R, Goeman JJ, Zweegers J, van de Kerkhof PCM, et al. Drug Survival Studies in Dermatology:Principles, Purposes, and Pitfalls. J Invest Dermatol. 2015;135(7):1-5.