PsoBest registry: Biologics have become the first choice in moderate-to-severe psoriasis

A comprehensive analysis from the German Psoriasis Registry, PsoBest, highlights the dynamic evolution of systemic drug use in psoriasis treatment over the past 15 years. A shift in the therapeutic landscape has occurred with biologics becoming the predominant choice for patients with moderate-to-severe disease.

The PsoBest evaluates clinical outcomes, safety, and use of systemic drugs for psoriasis and psoriatic arthritis in Germany. The registry includes more than 90% of the prescribers of biologics in Germany. Between 2008 and 2023, the PsoBest registry analysed 16,293 patients with a mean age of 47.6 years, 58.2% of whom were men [1]. Another 18.8% also suffered from psoriatic arthritis, and 46.8% of nail psoriasis.

Over this period, the proportion of non-biologics included fell from 67.7% to 13.5%. To the same extent, more biologics were used for registry reporting, reflecting advancements in biologic therapies and their growing role in clinical practice. The most frequently pre-exposed non-biological systemic therapeutics were fumaric acid esters (20.8% on average) and methotrexate (20%). Particularly, a dramatic rise was seen in the proportion of biologics given as first systemic therapy from 1.5% in 2008 to 32.8% in 2023.

The registry data further mirrors the progression of biological classes over time. From 2008 to 2015, tumour necrosis factor (TNF) inhibitors, such as adalimumab, were the most frequently prescribed class. From 2015 to 2018, IL-17 antagonists, such as secukinumab, became more prominent, followed by IL-23 inhibitors, the leading drug class since 2019. This data is supported by those from the statutory health insurance companies in Germany.

Despite these advancements, challenges remain. Patients with multiple prior systemic therapies demonstrate diminishing therapeutic responses over time, highlighting the need for continued innovation and personalised treatment approaches.

The dynamic shift towards biologics reflects significant progress in psoriasis treatment and mirrors the development of new drug classes. Registries such as the PsoBest are a valuable amplifier of the use of innovations for psoriasis.

1. 
   
   1. Augustin M. Drug supply for psoriasis in transition: 15 years of experience in the German Psoriasis Registry PsoBest. EPS02.08, EADV Congress 2024, 25–28 September, Amsterdam, the Netherlands.

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Medical writing support provided by Dr Susanne Kammerer



Posted on 1 October 20241 October 2024