Persistence of interleukin-17 and interleukin-23 inhibitors in patients with plaque psoriasis: a real-world study in Taiwan.

Objectives: IL-17 inhibitors (IL-17i) and IL-23 inhibitors (IL-23i) are advanced treatments for moderate-to-severe plaque psoriasis. This study aimed to assess the persistence of IL-17i and IL-23i in patients with plaque psoriasis in Taiwan, where a unique healthcare reimbursement policy makes biologic persistence highly reflective of real-world effectiveness.

Methods: We conducted a retrospective cohort study in bio-naïve patients with plaque psoriasis in Taiwan using the Chang Gung Research Database. Persistence was defined as the duration from initiation to discontinuatin of a biologic agent. Patients who were diagnosed with plaque psoriasis and initiated an IL-17i or an IL-23i between January 2015 and December 2022 were included. Persistence rates were estimated by Kaplan-Meier methods, using discontinuation as the event of interest.

Results: A total of 544 and 334 patients were included in the IL-17i and IL-23i cohorts, respectively. Numerically higher persistence was observed for IL-23i compared with IL-17i (p < 0.001). The 48-week and 96-week persistence rates were 71.3% (67.5-75.4%) and 55.2% (50.7-60.1%) for IL-17i, and 82.2% (78.1-86.6%) and 75.1% (70.1-80.5%) for IL-23i.

Conclusions: These findings may inform clinical decision-making by healthcare providers, patients, and policymakers. Further research integrating richer clinical information with extended follow-up will allow deeper investigation of biologic treatment patterns in real‑world settings.