Association between complete skin clearance (psoriasis area and severity index 100) and drug survival of biologics in patients with chronic plaque psoriasis: A single-center retrospective study

Song, Won Ji; Yoon, Hyun Sun

doi:10.1016/j.jaad.2023.06.022

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…Currently, the therapeutic objective for individuals with psoriasis has progressed from achieving remission to attaining total skin clearance (TSC), which represents a more ambitious goal [ 6 , 13 ]. As a ‘treat-to-target’ strategy, TSC improves the quality of life and pruritus symptoms, prolongs drug survival, and decreases the risks of complications such as psoriatic arthritis [ 14 , 15 ]. In this multicenter real-world study, fewer than half of all patients could achieve a TSC response after 12 weeks of IL-17 inhibitors treatment.…”

Section: Discussionmentioning

confidence: 99%

A novel online calculator based on clinical features and hematological parameters to predict total skin clearance in patients with moderate to severe psoriasis

Jiang,

Huang,

Chen

et al. 2024

J Transl Med

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Background Treatment responses to biologic agents vary between patients with moderate to severe psoriasis; while some patients achieve total skin clearance (TSC), a proportion of patients may only experience partial improvement. Objective This study was designed to identify potential predictors for achieving TSC in psoriasis patients treated with IL-17 inhibitors. It also aimed to develop an easy-to-use calculator incorporating these factors by the nomogram to predict TSC response. Methods A total of 381 patients with psoriasis receiving ixekizumab were included in the development cohort and 229 psoriasis patients who initiated secukinumab treatment were included in the validation cohort. The study endpoint was achieving TSC after 12 weeks of IL-17 inhibitors treatment, defined as the 100% improvement in Psoriasis Area and Severity Index (PASI 100). Multivariate Cox regression analyses and LASSO analysis were performed to identify clinical predictors and blood predictors respectively. Results The following parameters were identified as predictive factors associated with TSC: previous biologic treatment, joint involvement, genital area affected, early response (PASI 60 at week 4), neutrophil counts and uric acid levels. The nomogram model incorporating these factors achieved good discrimination in the development cohort (AUC, 0.721; 95% CI 0.670–0.773) and validation cohort (AUC, 0.715; 95% CI 0.665–0.760). The calibration curves exhibited a satisfactory fit, indicating the accuracy of the model. Furthermore, the decision curve analysis confirmed the clinical utility of the nomogram, highlighting its favorable value for practical application. Web-based online calculator has been developed to enhance the efficiency of clinical applications. Conclusions This study developed a practical and clinically applicable nomogram model for the prediction of TSC in patients with moderate to severe psoriasis. The nomogram model demonstrated robust predictive performance and exhibited significant clinical utility. Trial registration A multi-center clinical study of systemic treatment strategies for psoriasis in Chinese population;ChiCTR2000036186; Registered 31 August 2020; https://www.chictr.org.cn/showproj.html?proj=58256.

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