Review of maintenance of response to psoriasis treatments

Abstract

Abstract: Background: Biologics are highly effective treatments for moderate-severe psoriasis with a high percentage of patients achieving 75% improvement in Psoriasis Area Severity Index (PASI75) at 12 weeks. However, psoriasis is a chronic disease, and long-term efficacy is critical. Objective: Long-term responses of systemic psoriasis treatments and how this effect is reported. Methods: A PubMed literature was performed to identify studies describing long-term response rates to available systemic psoriasis treatments. Within these studies, we examined how maintenance rates were reported. All studies with long-term efficacy data ranging from 24 to 244 weeks were considered. Results: Thirteen studies met the inclusion criteria. When comparing medications at 1 year, response rates among the initial treatment groups were best with secukinumab (65.2%) and worst with apremilast (18.7%). Among only initial responders at 10–16 weeks who received 1 year of continuous treatment, maintenance was best with adalimumab (95.2%) and worst with apremilast (61%). Limitations: The different methodologies used to report maintenance of response over time make it difficult to compare response rates across drugs studied in different trials. Conclusion: Long-term response rates of systemic treatment of psoriasis are high. Effect may be influenced by many factors and can be analyzed in different ways, making comparisons across different trials difficult.