Incidence and risk factors for treatment failure with infliximab in psoriasis

A multicenter, prospective, observational study examining the impact of risk factors, such as BMI and waist circumference, on quality of life improvement and clinical response in moderate‐to‐severe plaque‐type psoriasis patients treated with infliximab in routine care settings of Greece

“…In agreement with other studies with biologic therapies, PASI 75 response attainment was not found to be associated with smoking status, alcohol consumption and age at disease onset, although smoking at initiation of anti‐TNFα therapy has been reported as a predictor of non‐response elsewhere . The only identified negative predictor of PASI 75 response attainment was the presence of comorbidities, supported by reports linking high comorbidity burden with psoriasis disease severity as well as with treatment failure with biologics …”

“…Notably, no impact of BMI at enrolment on baseline disease severity was identified herein, while a low correlation was observed between WC at enrolment and baseline PASI, with a previous study supporting a stronger correlation of WC than BMI with baseline PASI. 17 In agreement with other studies with biologic therapies, PASI 75 response attainment was not found to be associated with smoking status, alcohol consumption and age at disease onset, 20,21,28 although smoking at initiation of anti-TNFa therapy has been reported as a predictor of non-response elsewhere. 20 The only identified negative predictor of PASI 75 response attainment was the presence of comorbidities, supported by reports linking high comorbidity burden with psoriasis disease severity 35 as well as with treatment failure with biologics.…”

“…Additionally, there is only limited data generated in routine care settings of Greece shedding light on factors that may influence infliximab's clinical response and its impact on the health‐related QoL (HRQoL). Previous studies have indicated that apart from obesity, smoking, alcohol consumption and female gender are negatively associated with clinical response and drug survival of biologic therapies for psoriasis, but findings are inconsistent . Under this perspective, this observational prospective study aimed to examine the impact of age at disease onset, BMI and WC on disease severity of patients with moderate‐to‐severe plaque psoriasis, as well as to examine potential predictors of clinical response attainment and the impact of infliximab on the patients’ HRQoL as measured by the skin‐specific dermatology quality of life index (DLQI) instrument, in moderate‐to‐severe plaque psoriasis patients treated with infliximab in the routine care of Greece.…”

An evolution in switching therapy for psoriasis patients who fail to meet treatment goals

“…Certain patient demographic and clinical characteristics should be considered when selecting therapies that will minimize treatment failure. For example, overweight and obese patients may have better outcomes with infliximab or ustekinumab than with other biologics because dosing for these agents is based on body weight (20,23,51). Gender may also affect the pharmacokinetic properties of different biologics.…”

“…Gender may also affect the pharmacokinetic properties of different biologics. It has been observed that adalimumab has a shorter half-life in female versus male patients (47) and that male gender was associated with a reduced likelihood for infliximab treatment failure (51).…”