Redaktion

Psoriasis is a chronic inflammatory skin disease, and previous studies among Western populations have suggested an increased risk of cardiovascular events in patients with psoriasis. However, evidence from Asian populations remains limited. We evaluated the risk of major adverse cardiovascular events (MACE) in patients with psoriasis compared with patients who have atopic dermatitis (AD) using a large-scale administrative claims database from Shizuoka, Japan. We conducted a cohort study using the Shizuoka Kokuho Database, including patients aged ≥ 40 years who were newly diagnosed with psoriasis or AD between April 2012 and September 2022. Propensity score matching was used to balance age, sex, and baseline cardiovascular risk factors. The primary outcome was hospitalization for MACE, defined as myocardial infarction (MI) or stroke. Survival analyses were conducted, treating death as a competing risk. After 1:1 propensity score matching (n = 2208 per group), the mean age was 70 years. During a follow-up period (median 4.5 years for psoriasis and 4.4 years for AD), the incidence of MACE was 2.7% in both groups (hazard ratio 0.96, 95% confidence interval 0.67-1.38; p = 0.84). When analyzed separately, the risks of MI and stroke did not differ significantly between groups. Results were consistent across subgroups by psoriasis severity and in two sensitivity analyses. We observed no excess risk of MACE in Japanese patients with psoriasis compared with those with AD over a median follow-up of approximately 4.5 years. These findings suggest that the cardiovascular risk specifically attributable to psoriasis may be limited in the Japanese population.Weiterlesen

BackgroundBiologic therapies have transformed psoriasis management, and their incorporation into Brazil's public healthcare system (SUS) in 2019 expanded access nationwide. However, real-world utilization and perceptions remain incompletely understood.ObjectivesTo evaluate perceptions, barriers, and prescription patterns regarding biologic therapy among Brazilian dermatologists and patients five years after universal incorporation, while quantifying the prevalence of undertreatment.MethodsWe conducted two independent cross-sectional online surveys throughout 2024 among dermatologists (n = 225) and patients with psoriasis or psoriatic arthritis (n = 1,001). Data on demographics, clinical characteristics, and perceived barriers were analyzed.ResultsOverall, 64.9% of dermatologists prescribed biologics, with higher prescribing rates among younger physicians (p = 0.022), those with fewer years of practice (p = 0.013), higher patient volumes (p < 0.001), and practice in tertiary centers (p = 0.001). Only 25.5% of patients were receiving biologics, strongly associated with psoriatic arthritis (p < 0.001), with no difference between public and private care. Key barriers included perceptions that conventional therapies are sufficient (59.5%), insufficient training (38.0%), and administrative burden (45.5%), while patients mainly reported safety (45.7%) and cost (30.9%) concerns. Undertreatment was prevalent, affecting over 50% of patients with moderate-to-severe disease. While 71.3% of non-users were willing to start biologics, only 28.0% had received a medical recommendation.ConclusionsPersistent educational and structural barriers continue to limit optimal biologic use despite formal availability, highlighting the need for targeted education, streamlined care pathways, and improved physician-patient communication to achieve equitable outcomes.Weiterlesen

BackgroundThe clinical definition of moderate psoriasis is debated, affecting treatment eligibility and patient outcomes.ObjectiveA panel of Italian dermatologists aimed to propose practical criteria to define moderate psoriasis, based on a comprehensive literature review and clinical experience.MethodsThe panel reviewed publications between 2016 and 2024 focusing on key severity scores, including the Psoriasis Area and Severity Index (PASI), Body Surface Area (BSA), Dermatology Life Quality Index (DLQI), and Physician's Global Assessment (PGA), along with special area involvement and patient-reported outcomes.ResultsDespite variability among studies, and the lack of universally accepted thresholds, the panel defined moderate psoriasis as a BSA of 5%-10%, DLQI of 5-10, a PGA score of 3, and involvement of at least two special areas (e.g. scalp, face, genitals, nails, hands, or feet). Distressing itch and psychosocial impact were also recognized as critical elements influencing perceived disease burden. A composite PGA-based approach, integrating objective measures with patient-centered criteria, is proposed for identifying patients with moderate psoriasis who may benefit from systemic therapy.ConclusionThis pragmatic approach may help bridge the gap between guidelines and real-world clinical practice, ensuring more accurate treatment allocation and reducing undertreatment of psoriasis.Weiterlesen

No abstract supplied.Weiterlesen

ObjectiveTo compare on-label persistence among adults with psoriasis who switched from other advanced therapies to guselkumab versus subcutaneous tumor necrosis factor inhibitors (SC TNFi), subcutaneous interleukin-17 inhibitors (SC IL-17i), or apremilast.Materials and methodsThis retrospective cohort study used U.S. claims data from the IQVIA PharMetrics® Plus database (2016- 2023). Overlap propensity score weights were used to balance cohorts on baseline characteristics. On-label persistence was defined as the absence of drug discontinuation (event) and any dose change relative to the U.S. label (censoring). Survival analyses were used to assess on-label persistence from the start of the maintenance phase.ResultsAt 12, 18, and 24 months after the start of the maintenance phase, respectively, on-label persistence was 190%, 180%, and 179% more likely on guselkumab versus SC TNFi; 78%, 87%, and 91% more likely on guselkumab versus SC IL-17i; and 187%, 199%, and 193% more likely on guselkumab versus apremilast (all p < 0.001).ConclusionsPatients experiencing suboptimal outcomes with other psoriasis-indicated advanced therapies achieved higher on-label persistence after switching to guselkumab, raising the potential for improved disease control relative to other treatment options.Weiterlesen

BackgroundTo the best of our knowledge, no validated scoring instrument currently exists that comprehensively evaluates both cutaneous manifestations and systemic comorbidities of psoriasis. This multicenter study aimed to develop and validate a novel multidimensional scoring system addressing this clinical gap.MethodsUnder the guidance of the Shenzhen Psoriasis Academy, we conducted seven expert meetings to analyze existing evidence from PubMed, Wanfang, and CNKI databases. Through iterative Delphi consensus processes involving 26 specialists across 10 disciplines, we established the Psoriasis Disease Assessment Index (PSODAI). This 60-point composite instrument evaluates cutaneous involvement and nine key organ/system comorbidities. An accompanying online calculator (http://www.psodai.com.cn/) was developed for clinical implementation. Validation involved 254 psoriasis patients from six tertiary centers, with comparative analyses against PASI and DLQI metrics.ResultsThe PSODAI framework stratifies disease severity as mild (0-20), moderate (21-40), and severe (41-60). Comparative analysis revealed comparable proportions of moderate-to-severe cases between PSODAI and conventional tools (PASI/DLQI) (p>0.05). Notably, 11 patients (4.3%) classified as severe by PASI were re-categorized as mild through PSODAI's systemic evaluation, primarily due to limited extracutaneous manifestations.ConclusionAs the first comorbidity-integrated assessment tool, PSODAI enables cross-specialty collaboration for holistic patient management. Its clinical adoption may facilitate timely comorbidity detection and preventive interventions. Further multicenter validation is warranted to confirm these preliminary findings.Weiterlesen

# Neue Studie: Autoimmunerkrankungen und Herzrhythmusstörungen **Forscher der Universität Gießen haben untersucht, ob Autoimmunerkrankungen das Risiko für Vorhofflimmern erhöhen.**[2] Diese Studie basiert auf echten Patientendaten von deutschen Arztpraxen. Das ist wichtig für dich zu wissen: Menschen mit Autoimmunerkrankungen wie Psoriasis-Arthritis leben mit einer überaktiven Körperabwehr. Diese dauerhafte Entzündung kann nicht nur die Gelenke treffen, sondern auch das Herz beeinflussen. Vorhofflimmern ist eine Herzrhythmusstörung, bei der das Herz unregelmäßig schlägt.[4] Das erhöht die Schlaganfallgefahr. Andere Studien zeigen bereits: Patienten mit rheumatoider Arthritis haben ein etwa 1,5-fach höheres Risiko für Vorhofflimmern.[3] Die neue deutsche Studie schaut sich an, wie häufig diese Verbindung in der Praxis vorkommt und ob Männer und Frauen unterschiedlich betroffen sind.[2] Solche Erkenntnisse helfen Ärzte dabei, Menschen mit Autoimmunerkrankungen besser zu überwachen. Falls du mit Psoriasis-Arthritis lebst, ist es sinnvoll, dein Herz regelmäßig kontrollieren zu lassen. Das solltest du mit deinem Arzt besprechen. Originaltitel: Association between autoimmune diseases and atrial fibrillation: a real-world analysis from German outpatient data. Link zur Quelle

Originaltitel: Northwestern European Ancestry Predominates in Idiopathic Subglottic Stenosis: Results From an English-Speaking Cohort. Link zur Quelle

Originaltitel: The IL-36 cytokine family: From barrier immunity to therapeutic target in inflammatory diseases. Link zur Quelle

Originaltitel: Oncostatin M upregulates CD73 via the MAPK pathway in keratinocytes to promote an adenosine-dependent anti-inflammatory response in psoriasis. Link zur Quelle

Originaltitel: Air Pollution and Skin Diseases: A Systematic Review of Epidemiological Evidence. Link zur Quelle

Trial number: 2023-507415-35-00 Overall trial status: Ongoing, recruitment ended Trial title: A Phase III, Randomized, Double-Blind, Placebo-Controlled Study to Demonstrate the Efficacy and Safety of Tildrakizumab in Anti-TNF Experienced Subjects with Active Psoriatic Arthritis I (INSPIRE 1) Medical conditions: Psoriatic Arthritis Status in each country: Czechia:Ended, Germany:Ended, Estonia:Ended, Spain:Ended, Slovakia:Ongoing, recruitment ended, Italy:Ended, Poland:Ended Trial phase: Therapeutic confirmatory (Phase III) Therapeutic Areas: Diseases [C] - Skin and Connective Tissue Diseases [C17] Primary end point: The proportion of subjects who achieve ACR20 at Week 24 Secondary end point: N/A Age of participants: 18-64 years, 65+ years Gender of participants: Female, Male Trial region: In both EEA and non-EEA Planned number of participants: 204 Sponsor: Sun Pharmaceutical Industries Limited Sponsor type: Pharmaceutical company Trial product: Ilumetri 100 mg solution for injection in pre-filled syringe, tildrakizumab placebo solution for injection in pre-filled syringe Results posted: No Overall decision date: 31/05/2024 Countries decision date: PL: 21/06/2024, ES: 04/06/2024, IT: 01/07/2024, DE: 31/05/2024, CZ: 04/06/2024, SK: 31/05/2024, EE: 31/05/2024 Last updated date: 10/04/2025Den kompletten Artikel zeigen

No abstract supplied.Weiterlesen

No abstract supplied.Weiterlesen

# Biologika gegen Schuppenflechte: Auch bei Krebs sicher? Die neue Studie untersucht ein wichtiges Thema. Es geht darum, ob Biologika gegen Schuppenflechte gefährlich sind, wenn du gleichzeitig Krebs hast oder hattest. Das ist für viele Patienten eine große Sorge. Die gute Nachricht zuerst: **Biologika scheinen sicher zu sein**[1][5]. Ärzte können sie auch bei aktiven oder kürzlich diagnostizierten Krebserkrankungen einsetzen. Du musst deine Schuppenflechte also nicht leiden lassen, nur weil du Krebs hast. Allerdings gibt es Unterschiede zwischen den verschiedenen Biologika. **TNF-α-Hemmer** erhöhen das Krebsrisiko leicht[2]. Besonders das Lymphom-Risiko steigt. **IL-12/23-Hemmer** und **IL-17-Hemmer** sind dagegen besser[2][3]. Sie senken sogar das Gesamtkrebsrisiko oder beeinflussen es gar nicht. Experten empfehlen daher: Wenn du Krebs hast, wählt dein Arzt eher IL-17 oder IL-23-Hemmer[3]. Die Behandlung wird sehr individuell geplant. Es zählt deine ganze Situation. Das Wichtigste ist offene Kommunikation zwischen dir, deinem Hautarzt und deinem Onkologen. Gemeinsam findet ihr die beste Lösung für dich. Originaltitel: Comment on "Cancer progression, recurrence, and infection outcomes in psoriasis patients with active or recent malignancy treated with biologic therapy". Link zur Quelle

BackgroundPsoriasis is frequently accompanied by depression. However, the role of specific symptom domains, including cognitive-affective and somatic symptoms, as well as potential metabolic mediators between psoriasis and depression, remains unclear.MethodsWe analyzed data from the National Health and Nutrition Examination Survey (NHANES, n = 14,964) and the Health and Retirement Study (HRS, n = 4364). Depressive symptoms were classified into cognitive-affective and somatic domains. Cross-sectional associations were evaluated in NHANES, and longitudinal symptom trajectories were identified in HRS using group-based trajectory modeling. Based on genome-wide association study summary statistics, bidirectional and two-step Mendelian randomization (MR) were performed to assess causality and identify plasma metabolite mediators.ResultsIn NHANES, total depressive symptoms (OR = 1.03, 95% CI: 1.01-1.06, P = 0.018) and somatic symptoms (OR = 1.08, 95% CI: 1.03-1.12, P = 0.003) showed positive associations with psoriasis, but not cognitive-affective symptoms. In HRS, persistently high trajectories of total (OR = 1.58, 95% CI: 1.08-2.32, P = 0.018) was associated with psoriasis, with no significant association for the cognitive-affective and somatic domains after full adjustment. MR supported a causal relationship of psoriasis on depression and identified sphingomyelin (d17:2/16:0, d18:2/15:0) and urate as mediators, accounting for 10.2% and 6.8% of the total effect, respectively.ConclusionDepressive symptoms were linked to psoriasis in both cross-sectional and longitudinal analyses. Lipid and antioxidant-related pathways involving sphingomyelin and urate may mediate the relationship between psoriasis and depression, offering potential targets for intervention.Weiterlesen

No abstract supplied.Weiterlesen

BackgroundPsoriasis, a chronic autoimmune condition, can severely impact patients' well-being. It is characterized by erythema, thickening, and scaling of the skin. Plaque psoriasis, the most prevalent type, affects 80%-90% of psoriasis patients, ranging from localized to severe cases. Although corticosteroids are commonly used to treat psoriasis, prolonged use poses risks. Therefore, alternative therapies are needed. Roflumilast, a potent phosphodiesterase 4 inhibitor, is currently being considered as a treatment for plaque psoriasis.MethodsWe searched four electronic databases (Cochrane Central Register of Controlled Trials, PubMed, Scopus, and Web of Science) up to March 2024 for relevant articles evaluating the efficacy and tolerability of roflumilast in the management of psoriasis. The quality of evidence from trials was assessed using the Cochrane Risk of Bias tool (RoB1). Data from the included studies were extracted into a standardized online sheet and analyzed using RevMan 5.4.ResultsRoflumilast significantly increased the proportion of patients achieving an Investigator's Global Assessment score of 0 or 1 and a 2-point improvement score at both weeks 4 and 8 compared to placebo (RR = 3.48, 95% CI [2.04 to 5.92], P < 0.00001, and RR = 4.02, 95% CI [3.17 to 5.11], P < 0.00001, respectively). The pooled studies demonstrated homogeneity at both weeks 4 (P = 0.17, I² = 38%) and 8 (P = 0.38, I² = 5%). Regarding the results of the Psoriasis Area and Severity Index, 75% favored roflumilast over placebo (RR = 2.72, 95% CI [1.18 to 6.28], P < 0.00001, and RR = 3.41, 95% CI [2.19 to 5.32], P < 0.00001, at weeks 4 and 8, respectively). Subgroup analysis addressed the observed heterogeneity in the results.ConclusionThis meta-analysis represents the first investigation into the efficacy and safety of roflumilast for treating psoriasis. Results suggest that roflumilast is both effective and well-tolerated in managing psoriasis. However, additional robust clinical trials are needed to validate these observations..Weiterlesen

Interleukin-23 (IL-23) inhibitors represent a major advance in the management of moderate-to-severe plaque psoriasis, grounded in the central pathogenic role of the IL-23/Th17 axis. By selectively targeting the p19 subunit, guselkumab, risankizumab, and tildrakizumab effectively suppress disease-driving inflammation while preserving IL-12-mediated host defence. Pivotal randomized trials have demonstrated high levels of skin clearance, durable efficacy, and favourable safety profiles. Nevertheless, such trials only partially reflect the heterogeneous and medically complex populations treated in everyday practice. Against this background, this narrative review focuses on the expanding body of real-world evidence, which has provided novel insights into the long-term durability, drug survival, performance in difficult-to-treat anatomical sites, and safety of IL-23 inhibitors in special and comorbid populations. Real-world studies consistently confirm high effectiveness in elderly patients, individuals with multiple comorbidities, and those with extensive prior biologic exposure, as well as in challenging disease localisations such as scalp, nails, palmoplantar, genital, and pretibial psoriasis. Across large observational cohorts, IL-23 inhibitors show excellent treatment persistence, largely driven by sustained efficacy and low rates of discontinuation for adverse events. Reassuring safety profiles have also been documented in patients with a history of malignancy, latent infections, or cardiometabolic disease, together with improvements in quality of life and systemic inflammatory burden. By integrating evidence from randomized trials with large real-world cohorts, this narrative review provides a clinically oriented synthesis of the efficacy, safety, and therapeutic positioning of IL-23 inhibitors in psoriasis. Although all three agents demonstrate high and durable effectiveness, real-world data suggest subtle intraclass differences, with guselkumab and risankizumab often achieving faster or deeper early responses, and tildrakizumab offering greater dosing flexibility with comparable long-term persistence in selected patient profiles. Overall, IL-23 blockade has evolved from a highly effective trial-based strategy into a versatile and reliable long-term therapeutic approach capable of addressing unmet needs in routine clinical practice.Weiterlesen

IntroductionPsoriasis is a chronic inflammatory skin disease associated with significant physical and psychological burden. Tildrakizumab, an interleukin-23 p19 inhibitor, has demonstrated efficacy in treating moderate-to-severe plaque psoriasis both in clinical trials and real-world setting. However, limited data are available on the impact of the effective treatment of psoriasis on the psychological health of patients. The aim of this study was to assess changes in psychological well-being, as well as clinical and quality-of-life outcomes, in patients with moderate-to-severe plaque psoriasis treated with tildrakizumab in routine clinical practice in Italy.MethodsThis was an interim analysis (IA) of a 52-week multicenter, prospective, observational study. Adults with moderate-to-severe plaque psoriasis initiating tildrakizumab were enrolled. Endpoints focused on well-being and psychological health and included changes, from baseline to week 28, in Depression, Anxiety, and Stress Scale-21 (DASS-21) scores, Dermatology Life Quality Index (DLQI), European Social Survey (ESS) items, and World Health Organization-Five Well-Being Index (WHO-5). Effectiveness was also monitored via Psoriasis Area and Severity Index (PASI), and safety via treatment-emergent adverse event reporting.ResultsA total of 115 patients were included (mean age 52.5 years, 60.8% male), 102 receiving ≥ 1 dose of tildrakizumab and completing DASS-21 evaluations at baseline and week 28. At week 28, improvements were observed in DASS-21 subscales [depression (- 2.6, 95% CI - 2.0 to - 1.0), anxiety (- 2.3, 95% CI - 2.0 to - 1.0), and stress (- 3.4, 95% CI - 4.0 to - 2.0)], accompanied by marked PASI reduction (- 13.7, 95% CI - 12.8 to - 10.1). DLQI, ESS, and WHO-5 scores also improved. Adverse events were generally mild or moderate, with no unexpected safety signals.ConclusionIn this real-world IA, tildrakizumab was observed to improve the psychological well-being of patients, reflected by a reduction in all items of the DASS-21 scale and, in parallel, confirmed its effectiveness in managing physical symptoms of psoriasis, establishing its role in the holistic management of psoriasis.Weiterlesen

Abstract Objective To explore the clinical application value of Neutrophil extracellular traps (NETs) in evaluating psoriasis. Methods 2ml peripheral blood of 63 patients with psoriasis and 27 healthy controls were collected. Neutrophils were isolated by density gradient method, and the formation of NETs was observed by immunofluorescence staining. We then calculated the proportion and fluorescence intensity of NETs and analyzed their correlation with clinical classification, severity, and serological indicators. Furthermore, the skin lesions of 5 patients with psoriasis were collected, and the NETs were observed by immunofluorescence method. Results The proportion and fluorescence intensity of spontaneous NETs in patients with psoriasis were significantly higher than those in healthy controls and were positively correlated with the PASI scores. The generation of NETs in psoriasis patients with metabolic syndrome (MetS) or high-TNF-α was higher than in psoriasis patients without metabolic abnormalities or normal-TNF-α. NETs were also observed in most psoriatic skin specimens. Conclusions The levels of NETs are correlated with the disease severity of psoriasis and patients with metabolic abnormalities and may be used as a clinical indicator to reflect the inflammatory state of psoriasis and metabolic comorbidity of psoriasis for disease evaluation. Weiterlesen

Psoriasis is a chronic, relapsing inflammatory skin disease. Topical treatments are the primary choice for up to 80% of psoriasis patients; however, their effectiveness is often limited by poor penetration into the skin. Nanocarriers represent a promising advancement in drug delivery systems by enhancing bioavailability and tissue penetration and reducing the frequency of dosing. This study conducted a narrative review and analyzed the characteristics of clinical trials registered on ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP) that investigated the use of nanocarriers for psoriasis treatment. The findings indicate that the proportion of registered randomized controlled trials (RCTs) focusing on nanocarriers for psoriasis treatment is exceedingly limited, comprising only 0.2% (11 out of 5338) of all registered RCTs related to psoriasis treatment. Among these 11 RCTs, six types of nanocarriers were identified: microemulsion/nanoemulsion, chitosan nanoparticles, liposomes, ethosomes, micelles, and niosomes. Five trials reported complete or partial outcomes using the Psoriasis Area and Severity Index (PASI) as the primary efficacy measure. However, many trials had incomplete baseline and follow-up PASI data. Studies have shown that encapsulating APIs within nanocarriers generally yields a more significant reduction in PASI scores than administering empty nanocarriers. Additionally, no study has directly compared nanocarriers with traditional formulations. The APIs used in these RCTs primarily comprised lipophilic drugs. In conclusion, although nanocarriers for psoriasis treatment demonstrate significant potential, they continue to face challenges, including incomplete regulatory frameworks, difficulties in large-scale production, and high production costs.Weiterlesen

Abstract Background This study collected and analyzed clinical data from patients with psoriasis, developing and validating a risk prediction model for psoriasis relapse. The aim is to improve the efficiency and accuracy of early screening for psoriasis relapse in clinical practice and to provide a reference for implementing preventive measures. Objective To develop and validate a risk prediction model for psoriasis relapse. Methods A convenience sampling method was used to select 504 psoriasis patients admitted to a tertiary hospital in China between January 2022 and December 2024, including 353 cases in the training set and 151 cases in the test set. Independent risk factors for psoriasis relapse were identified through univariate analysis and logistic regression analysis to develop a prediction model. A nomogram and SHAP summary plot were generated for model visualization, and the model’s goodness of fit and discriminative ability were evaluated. Results The one-year relapse rate of psoriasis patients after treatment was 66.67%. Logistic regression analysis identified body mass index (BMI), diabetes, biologic agent use, smoking, upper respiratory tract infection (URTI), and non-standard medication as independent risk factors for psoriasis relapse, which were included in the model. The area under the ROC curve (AUC) values for the training and testing sets were 0.767 [95% CI: 0.715–0.818] and 0.704 [95% CI: 0.620–0.789], respectively. The model demonstrated good discrimination and calibration, and decision curve analysis (DCA) showed significant net benefit in both the training and testing sets. Conclusion The psoriasis relapse risk prediction model developed in this study demonstrated good predictive performance. This model can serve as an effective reference for assessing the risk of psoriasis relapse and provides valuable insights for developing personalized prevention strategies for patients. Weiterlesen

No abstract supplied.Weiterlesen

IntroductionInterleukin-17 inhibitors (IL-17i) and interleukin-23 inhibitors (IL-23i) are advanced therapeutic options for moderate-to-severe psoriasis. In real-world settings, biologic persistence is commonly used as a proxy for effectiveness and safety, and a treatment-free status following biologic discontinuation may provide insights into disease remission. This study aimed to assess persistence and treatment-free status for IL-17i versus IL-23i among biologic-naïve patients with psoriasis in Japan.Patients and methodsThis retrospective cohort study analyzed data from the Japanese Medical Data Vision database from 01 January 2015 to 31 December 2022. Patients diagnosed with psoriasis who initiated IL-17i or IL-23i during this study period were included. Persistence of the index biologic and post-discontinuation treatment-free status were assessed using Kaplan-Meier methodology. Propensity score methods with inverse probability of treatment weighting and matching were employed to control potential confounding between treatment cohorts.ResultsThere were 1,751 and 1,721 patients included in the IL-17i cohort and IL-23i cohort, respectively. Persistence rates for IL-17i were 55.7% [95% CI 53.2-58.1%] at the first year and 21.5% [95% CI 18.9-24.2%] at the fourth year, versus 77.7% [95% CI 75.4-79.8%] and 47.8% [95% CI 42.2-53.2%], respectively, for IL-23i. The risk of discontinuation of IL-23i was half that of IL-17i (adjusted hazard ratio [aHR]=0.49 [95% CI 0.44-0.54]). After discontinuation, 19.2% [95% CI 16.1-22.4%] and 31.5% [95% CI 27.8-41.2%] of patients in the IL-17i and IL-23i cohorts, respectively, remained treatment-free for at least 1 year. Patients treated with IL-23i had a lower risk for resuming systemic therapy after biologic discontinuation (aHR=0.57 [95% CI 0.49-0.67]).ConclusionIL-23i was associated with longer persistence and a longer post-discontinuation treatment-free period than IL-17i in patients with psoriasis. These findings may provide actionable insights for healthcare providers and patients as they develop treatment strategies. Future research integrating comprehensive clinical data is warranted to evaluate different treatment strategies, thereby informing clinical decision-making.Weiterlesen