Real-world studies on the use of biologics in psoriasis (Pso) are increasing, but still scarce. Next, interleukin-17 inhibitors (IL-17i) trough concentrations (Ct) seem promising for clinical decision making, however its value in daily practice has yet to be proven. Objectives were to report on IL-17i effectiveness, treatment modifications, and Ct use in our clinic. Data was collected from IL-17i treated Pso patients followed up in the PsoPlus clinic at the Dermatology department, Ghent University Hospital, Belgium. Descriptive statistics and Kaplan-Meier analysis were performed. A total of 111 patients were included, counting for 134 IL-17i courses. Fifty-five percent of the patients was biologic naive prior to IL-17i initiation. During maintenance, merely 97.0% and 80% achieved near-complete and complete skin clearance, respectively. Major reasons for treatment modification were: suboptimal response (63.0%) and safety issues (9.3%). Reported modifications were: switch (25.4%), dose escalation (11.9%), dose de-escalation (6.7%), treatment association (6.0%), and IL-17i stop (3.0%). Overall drug survival was 69.0 months, with no difference between the IL-17i (p = 0.078). Ixekizumab tended to have the highest survival. Drug survival was higher in biologic naive subjects compared to biologic experienced subjects (p=0.011). Ct was measured in 20 patients, and interpreted post hoc. In 85% the clinical decision was in accordance with the Ct (e.g. substantiated need for dose escalation). For the other cases, the Ct would have altered the decision if known ad hoc. This real-world study showed that IL-17i are very effective drugs for Pso. Prior biologic experience seemed to impact IL-17i drug survival. Treatment modifications were mainly performed in case of insufficient response, primarily via switch and dose escalation. Ct might rationalize clinical decision making, however there is need for standardized algorithms to corroborate its use.

ESDR139 - Blocking Interleukin-17 in Psoriasis: Real-world Experience from the PsoPlus Cohort

The scientific meeting of the European Society for Dermatological Research (ESDR) is held yearly, usually in September. With an international attendance of more than 1000 skin scientists from around the globe, the four-day event includes short oral presentations from peer-reviewed abstracts, keynote lectures from international experts, sponsored symposia, satellite programs, educational events as well as an important focus on posters, networking and building collaborations amongst scientists. For more information about this year’s meeting visit our website.