Thus, the present study, presented by Dr Oras Alabas (University of Manchester, UK), aimed to investigate whether HLA-C*06:02 affects the discontinuation of biologics in a large cohort of psoriasis patients in the real world [3]. BADBIR is a UK pharmacovigilance register designed to assess the long-term safety of newer drugs by following a real-world population of psoriasis patients of different sex, age, ethnicity, body mass index (BMI), and comorbidities. The population consisted of patients with chronic plaque psoriasis registered to BADBIR from 2007–2020. All patients were treated with adalimumab, etanercept, secukinumab, or ustekinumab, with at least 6 months follow-up, and HLA-C*06:02 data was available for all patients. Exposure time was calculated from initiation to the discontinuation of therapy and/or was censored at the latest follow-up.
Included in the analysis were 3,199 patients, of whom 52% were HLA-C*06:02 positive. Compared with HLA-C*06:02-negative psoriasis patients, they had an earlier onset of disease (onset <40 years in 94% of HLA-C*06:02-positive vs 85% in HLA-C*06:02-negative patients; P<0.001) and were less likely to have psoriatic arthritis (21% of HLA-positive vs 29% in HLA-negative patients; P<0.001). “The HLA-C*06:02-positive patients showed a better overall drug survival on ustekinumab compared with HLA-C*06:02-negative patients (HR 0.62; 95% CI 0.44–0.87; P<0.005). The same pattern was seen in adalimumab-treated patients with non-imputed data,” Dr Alabas explained. However, only the association with ustekinumab remained significant when using imputed data.
Further, HLA-C*06:02-positive patients had a 38% lower relative risk to stop treatment owing to lack of effectiveness than HLA-C*06:02-negative patients. HLA-C*06:02 status did not influence drug survival of patients discontinuing due to adverse events.
Thus, Dr Alabas concluded that HLA-C*06:02-positive patients treated with ustekinumab and maybe with adalimumab showed a lower risk of treatment discontinuation due to a lack of effectiveness in a real-world situation.
- Chen L, Tsai TF. Br J Dermatol 2018;178:854–62.
- Li K, et al. J Invest Dermatol 2016;136:2364–71.
- Alabas O, et al. HLA-C*06:02 allele is associated with higher drug survival in patients with psoriasis on ustekinumab: an analysis from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR), on behalf of the BADBIR and BSTOP. FC14, Psoriasis from Gene to Clinic 2021, 9–11 December.
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Table of Contents: PFGC 2021
Featured articles
Letter from the Editor
Guselkumab shows highest drug survival among systemic treatments
Genes in Psoriasis and Psoriatic Arthritis
HLA-C*06:02-positive patients on ustekinumab show higher drug survival in a real-world scenario
Protective factors identified against anti-drug antibody formation to adalimumab in psoriasis
Comorbidity in Psoriasis
Psoriasis associated with a higher cancer risk
Comorbidity and clinical features of psoriasis vary according to HLA-C*06:02 status
Psoriasis patients with cardiovascular comorbidity characterised by high systemic inflammation
Psoriasis Therapy: New Findings
Inhibition of heat shock protein: A novel way to treat psoriasis?
Guselkumab shows highest drug survival among systemic treatments
Tapering biologics: No alarming signs of increased anti-drug antibodies
Intermediate monocytes are possible predictors of response to secukinumab
Gut microbiota of psoriasis patients: less diverse and reduced functionality
COVID-19: What's New
DLQI scores underestimated during lockdowns?
TNF blockers likely beneficial for psoriatic patients with COVID-19
Patients on immunomodulators need 2 COVID-19 vaccinations before seroconversion
Paradoxical Reactions to Biologics
The Yin and Yang of opposing vectors: an explanation for side effects of biologics
Explaining arthropathy development through IL-4 and IL-13 blockade
Best of the Posters
Potential biomarker discovered for treatment response to ustekinumab
TNF inhibitor for immune-mediated inflammatory disease doubles the risk of paradoxical psoriasis
Secukinumab also tolerable in paediatric psoriasis patients
High treatment success with ixekizumab in patients with psoriasis and diabetes
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