Relationship between the efficacy of biologics and clinical plaque psoriasis subtypes in Japanese patients: A single‐center pilot study

• Published in: Journal of dermatology Vol. 46; no. 12; pp. 1160 - 1165
• Main Authors: Ito, Kotaro, Bayaraa, Bolortuya, Imafuku, Shinichi
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.12.2019
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Asian Continental Ancestry Group; Biological products; Biological Products - therapeutic use; biologics; clinical manifestation; drug survival; Female; Humans; Immunotherapy; Infliximab; Male; Middle Aged; Monoclonal antibodies; Patients; Pilot Projects; Plaques; Psoriasis; Psoriasis - drug therapy; Psoriasis - pathology; psoriasis vulgaris; Retrospective Studies; Skin - pathology; subtype; Survival; TNF inhibitors; Treatment Outcome; Tumor Necrosis Factor Inhibitors - therapeutic use; Tumor necrosis factor-TNF; Tumor necrosis factor-α; Young Adult; Japan; biologics; psoriasis vulgaris; subtype; drug survival; clinical manifestation
• ISSN: 0385-2407; 1346-8138
• DOI: 10.1111/1346-8138.15089

Although biologics for plaque psoriasis brought epoch‐making efficacy, not all patients achieve treatment success with all reagents. The aim of this study was to clarify the correlation between clinical plaque psoriasis subtypes, age at onset, and the efficacy of biologics. Clinical records for patients with plaque psoriasis at Fukuoka University Hospital were reviewed retrospectively. The efficacy of biologics was compared using the survival of the first biologics administered in treatment‐naïve patients. The survival of infliximab, adalimumab, and ustekinumab were followed until December 2016. The patients were clinically classified into three subtypes: small, large, or gigantic plaques using the size of the plaques on the back; early onset psoriasis (EOP, onset <40 years); or late‐onset psoriasis (LOP, ≥40 years). Eighty‐seven patients were enrolled. The survival of biologics was significantly better in large plaques compared with small or gigantic plaques (P = 0.0007). In patients treated with tumor necrosis factor (TNF) inhibitors, large plaques had significantly better survival than did the other types (P = 0.0122), while ustekinumab showed good survival in all three subtypes. The survival of biologics was numerically better in EOP than in LOP, but this was not significant. The efficacy of TNF inhibitors was different among clinical subtypes. Psoriatic patients with small plaques may be less responsive to TNF inhibitors. Further studies are needed.