This webpage provides lay summaries of key research papers in the field of dermatology, provided by the BAD Research Sub-Committe Trainee Representatives.
Iskandar IYK, Warren RB, Lunt M, Mason KJ, Evans I, McElhone K, Smith CH, Reynolds NJ, Ashcroft DM, Griffiths CEM; BADBIR Study Group. Differential Drug Survival of Second-Line Biologic Therapies in Patients with Psoriasis: Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR). J Invest Dermatol. 2018 Apr;138(4):775-784. doi: 10.1016/j.jid.2017.09.044. Epub 2017 Dec 6. PubMed PMID: 29080680; PubMed Central PMCID: PMC5869053.
Patients with moderate to severe psoriasis who have not responded adequately to conventional treatments, which can include topical treatment, light therapy, and tablet therapies, may require biologic therapies to control their disease. Although biologics can be extremely effective, they can lose their effectiveness with time, or be stopped due to side effects. Patients may therefore need to move on from their first biologic therapy to a second-line biologic and beyond.
This study looked at outcomes for patients on second-line biologics. Firstly, they found that at the end of the first year, 77% of patients were still being treated with their second-line biologic, falling to 58% in the third year.
They also found that patients whose treatment was stopped were generally females, with other medical conditions, who took another immune-suppressing treatments such as ciclosporin, and those who had more severe skin disease. They also found that compared to adalimumab, patients on etanercept were more likely to have their treatment be stopped, and patients on ustekinumab were less likely. Furthermore, if a patient's first biologic was stopped due to side effects, this increased the risk of their second biologic being stopped due to side effects also.
These study findings will aid dermatologists in making treatment decisions for patients with psoriasis about their second-line biologic treatment.