Association Between Short-Term PASI90 Achievement and Drug Survival of Biologics in Patients with Psoriasis.

Background: With accumulating evidence that achieving a 90% improvement in the Psoriasis Area and Severity Index score (PASI90) has better correlation with improved health-related quality of life as compared to PASI75 achievement, there has been demand for establishing new treatment goals for psoriasis. We investigated whether the short-term PASI90 achievement would predict longer drug survival as compared to PASI75 achievement. Objective: We investigated whether the short-term PASI90 achievement would predict longer drug survival as compared to PASI75 achievement. Methods: This single-center retrospective cohort study reviewed 180 treatment series in 128 patients with plaque psoriasis, who were treated with tumor necrosis factor-alpha inhibitors (n=12), ustekinumab (n=88), secukinumab (n=23), guselkumab (n=45), and ixekizumab (n=12). The first effectiveness assessment, usually performed within 12 to 20 weeks, was considered a short-term treatment response to biologics. Results: After adjustment for covariates, time-dependent Cox proportional hazards regression analysis showed that moderate responders (short-term achievement of ≥PASI75 but <PASI90) were more likely to discontinue therapy than the excellent responders (short-term achievement of PASI90; adjusted hazard ratio, 3.159; 95% confidence interval, 1.180~8.457; Conclusion: The short-term PASI90 achievement is a better predictor of longer drug survival as compared to PASI75 achievement.