AUTHOR=Piaserico Stefano , Riedl Elisabeth , Pavlovsky Lev , Vender Ronald B. , Mert Can , Tangsirisap Nithi , Haustrup Natalie , Gallo Gaia , Schuster Christopher , Brunner Patrick M. 

TITLE=Comparative effectiveness of biologics for patients with moderate-to-severe psoriasis and special area involvement: week 12 results from the observational Psoriasis Study of Health Outcomes (PSoHO)

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1185523

DOI=10.3389/fmed.2023.1185523

ISSN=2296-858X

ABSTRACT=Introduction: Psoriasis localized at the scalp, face, nails, genitalia, palms and soles can exacerbate disease burden. Real-world studies comparing the effectiveness of treatments for these special areas are limited.
Methods: Psoriasis Study of Health Outcomes (PSoHO) is an international, prospective, non-interventional, observational study comparing the effectiveness of anti-interleukin(IL)-17A biologics (ixekizumab, secukinumab) versus other approved biologics, and the pairwise comparative effectiveness of ixekizumab versus five other individual biologics for patients with moderate-to-severe psoriasis. To determine special area involvement, physicians answered binary questions at baseline and week 12. The proportion of patients who achieved special area clearance at week 12 was assessed. Missing outcome data were imputed as non-response. Comparative treatment analyses were conducted using Frequentist Model Averaging.
Results: Of the 1978 patients included, 83.4% had at least one special area involved at baseline with scalp (66.7%) the most frequently affected, followed by nails (37.9%), face/neck (36.9%), genitalia (25.6%) and palms and soles (22.2%). Patients with scalp, nail or genital, but not palmoplantar or face/neck involvement, had significantly higher odds of achieving clearance at week 12 in the anti-IL-17A cohort versus the other biologics cohort. Patients with scalp psoriasis had a 10-20% higher response rate and significantly greater odds (1.8-2.3) of achieving clearance at week 12 with ixekizumab compared to included biologics.
Conclusions: Biologics demonstrate a high level of clearance of special areas at week 12 in a real-world setting. Patients with scalp, nail or genital involvement have significantly higher odds of clearance at week 12 with anti-IL-17A biologics versus other biologics.