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Background: Drug survival, which refers to the time from treatment initiation to discontinuation, provides a surrogate measure of the effectiveness of a biologic in a real-world setting (J Invest Dermatol, 2015, 135, 1). The aim of this study was to determine the drug survival of biologics that are currently available in Australia. We also analysed the treatment efficacy of these biologics and reasons for discontinuation., Methods: Retrospective data from outpatient Dermatology biologic clinics in Westmead Hospital and Royal Prince Alfred Hospital (Sydney, Australia) from April 2006 to December 2020 were collected. Kaplan-Meier analysis was used to calculate drug survival., Results: A total of 306 patients who underwent 566 treatment courses were analysed. Guselkumab was observed to have the longest drug survival, with cumulative drug survival rates of 94.2% ± 4.0 at 1- and 5-years. This was followed by ixekizumab which had a 1-year survival rate of 87.2% ± 4.5 and 5-year survival rate of 59.4% ± 9.5. Ixekizumab and guselkumab were also noted to have superior treatment efficacy compared with other biologics, with PASI-75 rates of 94.9% and 93.8%, respectively. The most common reasons for treatment discontinuation were a lack of initial efficacy to treatment and a loss of efficacy over time despite an initial response, respectively., Conclusion: To our knowledge, this is the first Australian study to report on outcomes of multiple new biologics that are currently in use for the treatment of chronic plaque psoriasis. Overall, this study provides insight into patterns of care from a local experience that may help guide the management of moderate-to-severe psoriasis., (© 2024 The Authors. Australasian Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Australasian College of Dermatologists.)

Studies on the psychosocial and emotional burden of psoriasis have been extensive; however, there is limited knowledge and awareness of patients' attitude and behavior towards psoriasis treatment. To understand psoriasis patients' attitude and behavior towards treatment of psoriasis, especially those treated with biologics, a multi-stage study qualitative and quantitative methodology was conducted among psoriasis patients. An online survey was conducted with 45 moderate-to-severe psoriasis patients each in Australia, Japan, South Korea, and Taiwan for 20 min. This was followed by qualitative in-depth interviews conducted among psoriasis patients in Australia (n = 3) and Japan (n = 2) for 60 min. All of the findings were workshopped with key opinion leaders and patient advisory groups to identify potential solutions addressing patients' unmet needs. Five common insights were identified across the region, highlighting patients' attitude and behavior towards psoriasis treatment, especially for those treated with biologics. These insights comprised the following: (i) one of the key factors driving patients' treatment choice included their ability to enjoy clear skin for longer period (68%); (ii) bio-maintenance patients had a higher expectation (4.9 months) of how long their skin could stay clear, compared to their pre-biologics initiation days (2.9 months); (iii) once a good response is achieved, bio-maintenance patients were more concerned about symptoms returning (44%) than development of side-effects (19%); (iv) bio-maintenance patients felt psychologically and physically affected during flare-ups despite being on more efficacious treatment; and (v) bio-maintenance patients still felt they were at risk of flare-ups (4.5/7), almost similar risk perception as non-biologics patients (4.9/7). Findings from this study showed that psoriasis patients look for treatment with the least risk of flare-ups so that they were able to enjoy clear skin for a long time., (© 2021 The Authors. The Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Japanese Dermatological Association.)

Background: Psoriasis is a chronic disease that may require long-term treatment. Ixekizumab (IXE), which is a high-affinity monoclonal antibody that selectively targets interleukin 17A, is an approved therapy for patients with moderate-to-severe plaque psoriasis., Objective: To evaluate the efficacy and safety of IXE through 156 weeks from the UNCOVER-3 study in patients who were treated with the recommended dose regimen (160 mg of IXE at week 0, 80 mg every 2 weeks up to week 12, and 80 mg every 4 weeks thereafter)., Methods: Patients randomized to IXE every 2 weeks, IXE every 4 weeks, etanercept twice weekly, or placebo were switched to IXE every 4 weeks during the long-term extension period. Efficacy data were summarized by using the as-observed, multiple imputation, and modified nonresponder imputation methods., Results: At week 156, 80.5% of patients had achieved at least a 75% improvement from baseline in their Psoriasis Area Severity Index (PASI) score, 66.0% had achived at least a 90% improvement from baseline in their PASI score, and 45.1% had achieved a 100% improvement from baseline in their PASI score with use of the modified nonresponder imputation method, and 97.2% and 86.2% of patients had achived at least a 75% improvement from baseline in their PASI score with use of the as-observed and multiple imputation methods, respectively. Similar response rates were observed in patients with baseline scalp, nail, or palmoplantar involvement. No new safety signals were identified through year 3., Limitations: No placebo or active comparison after week 12., Conclusion: IXE sustained high responses with clearance of skin and nail lesions, with no new safety concerns through 3 years., (Copyright © 2018. Published by Elsevier Inc.)

Background Methods Results Conclusions The advent of novel biologics has led to an increase in biologic‐switching as patients and clinicians pursue improved clinical outcomes. However, guidance on treatment sequencing in an Australian setting is sparse. This study examines the patterns of care across two tertiary centres in Australia and characterizes the factors contributing to biologic‐switching.A retrospective study of patients who attended the outpatient Dermatology biologic clinics across two tertiary hospitals was conducted. Data on treatment sequencing and patients' PASI at every visit from April 2006 to December 2020 were collected. Patterns of biologic‐switching were examined. The speed of treatment response for each biologic was determined by the time to achieve PASI‐90 and ‐100 for each treatment course.A total of 440 treatment courses were analysed. Ustekinumab and adalimumab were the most frequently prescribed first‐line biologics. The highest proportion of biologic‐switching was observed among patients on TNF‐α inhibitors (63.8%). After 2015, more patients were prescribed IL‐12/23 and IL‐17 inhibitors in favour of TNF‐α inhibitors. IL‐17 inhibitors demonstrated the most rapid treatment response and low PASI scores relative to other biologics. Patients who did not switch biologics had lower rates of psoriatic arthritis and lower BMI, compared to patients who switched biologics. The median PASI on discontinuation generally exceeded 3.0, while on continuation, it was less than 1.2, reflecting patients' and clinicians' thresholds for biologic‐switching.This study demonstrates an increased uptake of more novel biologics as they become available, due to improved safety profiles and clinical outcomes. [ABSTRACT FROM AUTHOR]