Background Drug survival is an important measure of successful treatment of patients with chronic diseases such as psoriasis. Therefore, the objective was to calculate drug survival and examine safety profile of biologics and immunomodulators (adalimumab, apremilast, etanercept, ixekizumab, infliximab, secukinumab, and ustekinumab) from the Slovenian National Registry of patients with moderate‐to‐severe psoriasis. Methods Data about the patients with moderate‐to‐severe plaque psoriasis treated with biologics were collected from 2005 until July 2018. Kaplan‐Meier survival curves and Cox regression were used to calculate drug survival, where ustekinumab was selected as a reference. Results Overall, 1,606 patients were analyzed within 2,241 treatment episodes; adalimumab N = 831, apremilast N = 94, etanercept N = 101, ixekizumab N = 98, infliximab N = 164, secukinumab N = 340, and ustekinumab N = 613, respectively. Loss of efficacy was the most frequent reason for treatment discontinuation (contributing to 66.1% of all discontinuations). Ustekinumab was associated with the highest drug survival, meanwhile apremilast was the drug with the lowest survival rate compared to all others. Both IL‐17 inhibitors, secukinumab and ixekizumab, showed similar survival rate. Conclusions Ustekinumab was associated with the highest drug survival and most favorable safety profile compared to other biologics. Drug survival rates can be associated with the class effect of biological targets. Highest survival rate was observed for IL‐12/23 inhibitor, followed by IL‐17 and TNF‐α inhibitors, and last by an immunomodulator such as apremilast. Adverse events occurred most frequently with TNF‐α inhibitors.

No abstract

No abstract

Summary Background Psoriasis is associated with an increased risk of developing atherosclerotic vascular disease. The hypothesis that treatment of the skin inflammation may decrease the risk of developing atherosclerosis and consequently, cardiovascular disease, is currently a focus of significant attention. Aim To assess the effect of biologic drugs targeting the interleukin (IL)‐23/IL‐17 axis on selected subclinical atherosclerosis parameters in patients with psoriatic disease. Methods In a series of patients with moderate to severe psoriasis who were eligible for biologic therapy, pulse wave velocity (PWV) and intima–media thickness (IMT) were determined before therapy and after 6 months of treatment with biologics (ustekinumab, secukinumab, ixekizumab). Results After 6 months of treatment, a marked clinical improvement of skin lesions was observed in all patients. No significant changes in PWV or IMT values were observed before (8.59 ± 1.96 mm and 0.54 ± 0.9 mm, respectively) and after 6 months (8.89 ± 2.02 mm and 0.53 ± 0.9 mm) of therapy (P = 0.16 and P = 0.74). Conclusions Systemic treatment of patients with a psoriatic disease with biologics targeting the IL‐23/IL‐17 axis has a possibly neutral effect on atherosclerosis. Additional studies are needed to assess the impact of newer biologic treatments on atherosclerosis.

No abstract