Characterization and treatment outcomes of biologic therapy in super-responders and biologic-refractory psoriasis patients: A single-center retrospective study in China

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Despite advances in the availability of effective biologics in psoriasis over the past decade, clinical characteristics, persistence, and safety associated with treatment response have never been systemically investigated. To evaluated the factors, persistence and safety associated with super response (super-responder, SR) or refectory (biologic-refractory patient, BRR) to biologic agents, we conduct a retrospective analysis of psoriasis patients who initiated their first biologic therapy at the Department of Dermatology of Xiangya Hospital. In total, 737 patients were included (140 SRs [19.0%], 34 BRPs [4.6%]). We found normal body mass index, low Charlson Co-morbidity Index, without psoriatic arthritis, with family history of psoriasis, and low insulin resistance level were significantly associated with SRs, whereas obesity, with non-alcoholic fatty liver disease, high psoriasis area and severity index, and high erythrocyte sedimentation rate level were independent predictors of BRPs. SRs were associated with treatment persistence of biologics, but BRPs were linked with poor persistence and higher incidences of adverse events—particularly paradoxical eczema. In conclusion, our study identified predictors of response which may facilitate accurate drug targeting with good persistence and reassuring safety for psoriasis patients.

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