Treatment sequences in moderate-to-severe psoriasis: a hospital-based retrospective analysis.

IF 4 3区医学 Q2 BIOTECHNOLOGY & APPLIED MICROBIOLOGY

Expert Opinion on Biological Therapy Pub Date : 2025-09-01 Epub Date: 2025-08-01 DOI:10.1080/14712598.2025.2542508

Angela Boccia, Valentina Giunchi, Luca Girau, Carlotta Lunghi, Michelangelo La Placa, Federico Bardazzi, Elisabetta Poluzzi

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引用次数: 0

Abstract

Background: For moderate-to-severe psoriasis, clinical guidelines recommend biologic treatments after failure of at least one traditional systemic therapy. Biologics target different pathways, but a common challenge is loss of efficacy, often requiring a switch. This study explores real-world therapeutic management of moderate-to-severe psoriasis, focusing on biologic treatments.

Methods: A retrospective study was conducted using health records of adult patients currently receiving biologics at Sant'Orsola Hospital in Bologna. Therapeutic sequences were investigated using state sequence analysis. Within-sequence Shannon entropy was calculated and used as the outcome in linear regression models. A directed acyclic graph informed the hierarchical regression models to identify factors influencing treatment duration.

Results: The cohort included 364 patients. Adalimumab was the most common first-line biologic (27%), followed by secukinumab (18%) and etanercept (16%). Nearly half of patients (48%) switched treatments. Increasing age was associated with lower sequence heterogeneity (β = -0.001, p = 0.002). Ustekinumab demonstrated the longest median treatment duration (1,841 days), while etanercept had the shortest (639 days). After adjusting for confounding variables, ustekinumab maintained its positive effect on treatment duration (β = 0.285, p = 0.009).

Conclusion: The treatment duration for ustekinumab was encouraging, supporting its potential role as a durable option in these patients.

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中重度牛皮癣的治疗顺序：基于医院的回顾性分析

背景：对于中重度牛皮癣，临床指南建议在至少一种传统全身治疗失败后进行生物治疗。生物制剂针对不同的途径，但一个共同的挑战是功效丧失，通常需要转换。本研究探讨了现实世界中重度牛皮癣的治疗管理，重点是生物治疗。方法：对目前在博洛尼亚圣奥索拉医院接受生物制剂治疗的成年患者的健康记录进行回顾性研究。使用状态序列分析研究治疗序列。计算序列内香农熵，并将其作为线性回归模型的结果。一个有向无环图通知层次回归模型，以确定影响治疗时间的因素。结果：该队列包括364例患者。阿达木单抗是最常见的一线生物药物（27%），其次是secukinumab（18%）和依那西普（16%）。近一半的患者（48%）转而接受治疗。随着年龄的增加，序列异质性降低（β = -0.001, p = 0.002）。Ustekinumab的中位治疗持续时间最长（1841天），而依那西普的中位治疗持续时间最短（639天）。在调整混杂变量后，ustekinumab对治疗时间保持了积极作用（β = 0.285, p = 0.009）。结论：ustekinumab的治疗持续时间令人鼓舞，支持其作为这些患者持久选择的潜在作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Opinion on Biological Therapy 医学-生物工程与应用微生物

CiteScore

8.60

自引率

0.00%

发文量

审稿时长

3-8 weeks

期刊介绍： Expert Opinion on Biological Therapy (1471-2598; 1744-7682) is a MEDLINE-indexed, international journal publishing peer-reviewed research across all aspects of biological therapy. Each article is structured to incorporate the author’s own expert opinion on the impact of the topic on research and clinical practice and the scope for future development. The audience consists of scientists and managers in the healthcare and biopharmaceutical industries and others closely involved in the development and application of biological therapies for the treatment of human disease. The journal welcomes: Reviews covering therapeutic antibodies and vaccines, peptides and proteins, gene therapies and gene transfer technologies, cell-based therapies and regenerative medicine Drug evaluations reviewing the clinical data on a particular biological agent Original research papers reporting the results of clinical investigations on biological agents and biotherapeutic-based studies with a strong link to clinical practice Comprehensive coverage in each review is complemented by the unique Expert Collection format and includes the following sections: Expert Opinion – a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results; Article Highlights – an executive summary of the author’s most critical points.