Background and importance Psoriasis is a chronic, relapsing, immunologically mediated inflammatory dermatosis. Disease control is key to the physical, emotional and psychological well-being of patients.
Aim and objectives The main objective of the study was to identify the biological drugs chosen by the dermatologists at our centre as the first-line to treat psoriasis. The secondary objective was to determine the persistence of the drugs used in the first-line treatments.
Material and methods An observational, descriptive and retrospective study was carried out on patients diagnosed with psoriasis who were treated with selective immunosuppressive biological medication in our centre between 2016 and 2020. Data were collected from the medical history and the medication prescription program.
Results A total of 160 patients who started biological treatment for psoriasis were included; 38.8% were women. The mean age of the patients was 52±14.5 years. The treatments used in first-line therapy of psoriasis were: ustekinumab 42.5%, adalimumab 21.3%, apremilast 12.5%, secukinumab 10%, etanercept 8.8% and ixekizumab 3.1%. Only 3 patients started with brodalumab, guselkumab or infliximab, and none with certolizumab-pegol, risankizumab or tildrakizumab as first choice treatment. Those therapies with only one patient on treatment were excluded from the secondary endpoint analysis.
The treatments with the longest persistence were: etanercept (1296±418 days), ustekinumab (1090±739 days), secukinumab (813±368 days), adalimumab (803±664 days), ixekizumab (715±343 days) and apremilast (713±336 days).
Only 43.13% of the initiations were anti-TNF-α drugs.
Conclusion and relevance The result of the study shows the preference of ustekinumab as the first option by the dermatologist at our centre in the treatment of psoriasis, over others that are included in the regional guides. The study results show the preference of ustekinumab as the first option by the dermatologists in our centre in the treatment of psoriasis, compared to other drugs that are included in the regional opinion.
The drug with the longest persistence was etanercept, followed by ustekinumab, probably because they were the first commercialised molecules. The treatment durations show great interindividual variability.
With the arrival of new biological drugs indicated in this pathology, it is the job of the specialist pharmacist to promote the rational and protocolised use of the drug within the hospital’s pharmacotherapeutic commissions.
Conflict of interest No conflict of interest
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