Background and importance In the past years, many biological drugs have been approved for the treatment of moderate-to-severe plaque psoriasis.

Aim and objectives We aimed to describe the population of outpatients treated with biological drugs for moderate-to-severe plaque psoriasis according to the number and type of therapeutic shifts.

Material and methods We identified patients treated with a biological drug for moderate-to-severe plaque psoriasis (code ICD-9-CM 696.1 other psoriasis) from February 2017 to September 2020. Data were collected from drug refills by our pharmacy and electronically recorded. Biological drugs were considered according to the mechanism of action: anti-TNF-α (adalimumab, certolizumab, etanercept), anti-IL-17 (brodalumab, ixekizumab, secukinumab) and anti-IL-23 (guselkumab, risankizumab, tildrakizumab and ustekinumab). The therapeutic shift was intended as a change in the active substance, regardless of changes from an originator to its biosimilar/s, the pharmaceutical form (pen or syringe) or the dose.

Results From February 2017 to September 2020, 357 patients were treated with at least one biological drug for plaque psoriasis. Median age was 50.7 years (range 5.9–91.7) and 221 (61.9%) patients were men. 282 patients (79%) were treated with only one biological drug: 75 patients with anti-TNF-α, 132 with anti-IL-17 and 75 with anti-IL-23. 65 patients (18.2%) were treated with two biological drugs in sequence (table 1).

Conclusion and relevance More than 97% of patients were treated with only one (79%) or two (18.2%) biological drugs for moderate-to-severe plaque psoriasis, with a prevalence of anti-IL-17. Further investigation of the causes for the change from one to another biological drug is needed. These could include adverse events, ineffectiveness or other reasons.

Conflict of interest No conflict of interest