Abstract
Biologics are efficacious for treating psoriasis vulgaris (PsV) and psoriatic arthritis (PsA), but sometimes they are terminated or changed for various reasons, including ineffectiveness or adverse events. To find the optimal choice of biologics for treating psoriasis and psoriatic arthritis, we previously reported the real-world data on drug survival and the reason for terminating or switching biologics, summarizing data from 2010 to 2017. We updated our conclusions with the 2018 data, including the newly released guselkumab. By analyzing medical records from patients with PsV or PsA. Who visited the Department of Dermatology, Fukuoka University Hospital from 2010 to 2018. A total of 229 patients (168 men and 61 women) received biologics. The total number of patients treated with biologics fell for the first time since 2010 in 2018, and 147 patients (64%) were treated with only one biologic; 82 patients (36%) were switched to different products. Frequently used biologics in PsV were ustekinumab (UST), infliximab and adalimumab when calculated by total patient-year. Tumor necrosis factor inhibitor (TNFi) use decreased while UST and interleukin (IL) -17 inhibitors increased in newly introduced patients. Within the IL-17 inhibitors, use of secukinumab was reduced, and newer IL-17 inhibitors were more frequently introduced. In patients with PsA, TNFi's were more frequently employed than in those with PsV, but IL-17 inhibitors shared more than half of the total use. Further research is needed to find the optimal choice of biologics with larger samples at multiple facilities.
