Some are super responders to biologic treatments for psoriasis

[Fred]

This study looked at the prevalence and characterization of treatment-refractory psoriasis and super-responders to biologic treatment.

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Introduction
Treatment with biologics often leads to clearance of psoriasis. However, some patients do repeatedly fail to respond and/or lose an achieved response (treatment refractory) to the biologic, whereas other patients achieve excellent response to one biologic and remain clear of psoriasis for several years (super-responders).

Objective
To identify and characterize patients with treatment refractory psoriasis and patients who are super-responders to biologic treatment.

Material and methods
Patients registered in DERMBIO between January 2007 and November 2019 were included. Patients were categorized as being treatment refractory if they had had treatment failure to ≥3 biologics targeting ≥2 different pathways. Super-responders were patients treated with their first biologic for minimum 5 years without an absolute psoriasis area and severity index (PASI) > 3 between 6 months and 5 years of treatment. All remaining patients from DERMBIO served as comparators.

Results
In total, 3280 patients were included with a mean age of 45.0 years. 1221 (37%) of the patients were females. Of the included patients, 214 (6.5%) were categorized as treatment refractory and 207 (6.3%) were categorized as super-responders. Treatment refractory patients had higher mean body weight (100.6 kg vs. 90.6 kg, P < 0.0001) and higher mean BMI (32.2 vs. 29.4, P < 0.0001) compared with the rest of patients in DERMBIO. Super-responders had higher socioeconomic status and fewer comorbidities compared with the comparator group (P < 0.0001).

Conclusion
A small proportion of patients with psoriasis treated with biologics are either super-responders or treatment refractory. Treatment refractory patients have higher body weight, whereas super-responders have fewer comorbidities and higher socioeconomic status.

Source: onlinelibrary.wiley.com

*Early view funding unknown.

Biological Treatments For Psoriasis

[Caroline]

Very interesting.
Unfortunately they are real small numbers who are over achievers or under achievers, 6,3% and 6,5%

Statistically seen that means that the bulk of the patients, 87,2%, which is most of us, just perform normally with the diverse bio’s.



It is really odd that the under achievers are significantly found in the obese corners and the over achievers have a very good socioeconomic status…
That people without comorbidities do better than the ones that have comorbidities, does sound quite logical in my ears.

[Forest Walker]

It may be possible that some of the super responders increased their activities (exercise included) as their positive response to the first biologic may have led to better health.  Being healthy makes working and earning income easier, too.  I am wondering if the response or lack of response may have some impact on weight and income.

[D Foster]

I am not sure what the conclusions are really.
It's a good job that I wasn't in the survey because I am definitely overweight but I have been on Stelara,my first bio, for around nine years now so where would I fit in.