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Background: Genetic predictors for treatment response could optimize allocation of biological treatment in patients with psoriasis. There is minimal knowledge about pharmacogenetics of anti‐IL‐17 agents. Objectives: To assess whether genetic variants in the protein‐coding region or untranslated regions of the IL‐17A gene are associated with response to IL‐17A inhibitors in patients with psoriasis. Methods: This was a multicenter European cohort study investigating pharmacogenetics of IL‐17A inhibitors in patients with psoriasis. Patients with plaque psoriasis treated with secukinumab or ixekizumab in daily practice were included. For all participants, the protein‐coding region and untranslated regions of the IL‐17A gene were analysed using Sanger sequencing. Identified genetic variants were tested for association with response to secukinumab/ixekizumab, measured as ∆PASI, after 12 weeks (primary outcome) and after 24 weeks (secondary outcome). Association was tested using a linear regression model with correction for baseline PASI as a fixed covariate and for biological naivety and body mass index as additional covariates. Results: In total, 134 patients treated with secukinumab or ixekizumab were included. Genotyping of the cohort identified genetic variants present in untranslated regions and intronic DNA, but not in the protein‐coding region of the IL‐17A gene. Five genetic variants in non‐coding DNA with a known or suspected functional effect on IL‐17A expression were selected for association analyses: rs2275913, rs8193037, rs3819025, rs7747909 and rs3748067. After 12 weeks, 62% of patients achieved PASI75 and 39% achieved PASI90. At week 24, PASI75 and PASI90 response rates were 72% and 62%, respectively. No associations were found between the five genetic variants and ∆PASI, PASI75 or PASI90 after 12 and 24 weeks of anti‐IL‐17A treatment. Conclusions: Response to IL‐17A inhibitors secukinumab and ixekizumab cannot be explained by genetic variation in the protein‐coding and untranslated regions of the IL‐17A gene. Pharmacogenetics of IL‐17A inhibitors in the treatment of psoriasis requires further exploration. Linked Commentary: K. Eyerich J Eur Acad Dermatol Venereol 2020; 34: 11–12. https://doi.org/10.1111/jdv.16047. [ABSTRACT FROM AUTHOR]

High-resolution HLA typing identifies a new "super responder" subgroup of HLA-C*06:02-positive psoriatic patients: HLA-C*06:02/HLA-C*04, in response to ustekinumab Cumulative probability of drug survival in HLA-C*06:02-POS and HLA-C*06:02-NEG patients (d) as well as patients in subgroups of HLA-C*06:02-POS patients: HLA-C*06:02/HLA-C*04, HLA-C*06:02/HLA-C*07 and HLA-C*06:02/HLA-C*12 (e). The 2-year retention rate was 81% in HLA-C*06:02-POS patients and 54% in HLA-C*06:02-NEG patients, with significant difference observed between groups (HR: 0.30, 95% CI: 0.14-0.63; I P i = 0.002; Fig. d). [Extracted from the article]

Discontinuation rates ranged from 1.4% for patients using guselkumab to 5.5% for those treated with infliximab, when the decision was taken by the patients, while ranged between 0.5% for ixekizumab-treated patients and 2.8% for adalimumab-treated when the decision was taken after dermatological consultation. Patients and dermatologists are satisfied using biologics for psoriasis treatment. The impact of COVID-19 pandemic on patients with chronic plaque psoriasis being treated with biologic therapy: the Northern Italy experience. [Extracted from the article]

Background: Few studies have compared the efficacy of switching to adalimumab in the real‐life setting in plaque psoriasis patients. Objective: To evaluate the effect of adalimumab in psoriasis patients previously treated with other biologics. Methods: In this multicentre study, psoriasis patients (N = 262) treated with an anti‐TNF‐alpha agent, ustekinumab or naïve to biologics then switched to adalimumab were included. Disease severity was assessed by the Psoriasis Area and Severity Index (PASI) at baseline and after 3, 6, 12, 24 and 36 months. The association between clinical risk factors and achievement of PASI response was evaluated by logistic regression. Results: Adalimumab treatment resulted in a decrease in PASI (15.1 ± 6.2 at baseline vs. 2.7 ± 4.8 at 6 months, P < 0.0001), regardless of previous biologic treatment. Furthermore, adalimumab allowed 92.5%, 79% and 56% of patients to achieve PASI response (PASI 50, 75 and 90, respectively) and complete remission (PASI 100 response) in 48.4% of patients, by 6 months and maintained over 3 years, independent of prior biologic treatment. The absence of metabolic syndrome, dyslipidemia, hypertension and lower PASI and lower age at baseline was associated with achievement of PASI response at 3, 6 and 12 months, whereas at later time points (24 and 36 months), PASI 90 and PASI 100 response was associated with diagnosis of psoriasis/psoriatic arthritis. Conclusion: Adalimumab was effective at reducing PASI score over 3 years, irrespective of whether patients were biologic naïve or previously treated with a TNF‐alpha or IL‐12/23 inhibitor. [ABSTRACT FROM AUTHOR]