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Giornale Italiano di Dermatologia e Venereologia 2018 February;153(1):5-10

DOI: 10.23736/S0392-0488.16.05463-8


language: English

Switching from a biological therapy to another biologic agent in psoriatic patients: the experience of PsOMarche group

Giulia GANZETTI 1, Anna CAMPANATI 1 , Alberta BETTACCHI 2, Giuliano BRANDOZZI 1, Valerio BRISIGOTTI 1, Leonardo BUGATTI 3, Ivana CATALDI 1, Giorgio FILOSA 3, Alfredo GIACCHETTI 4, Giuseppe LEMME 1, Lorenzo MORRESI 5, Massimiliano NICOLINI 3, Valentina POSTACCHINI 1, Giuseppe RICOTTI 4, Laura ROSA 1, Marco SIMONACCI 2, Annamaria OFFIDANI 1

1 Dermatological Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy; 2 UOC Dermatologia, Hospital of Macerata, ASUR Marche AV3, Macerata, Italy; 3 UOC Dermatologia, Carlo Urbani Hospital, ASUR Marche AV2, Jesi, Ancona, Italy; 4 UOC Dermatologia INRCA/IRCCS, Ancona, Italy; 5 Unit of Dermatology INRCA/IRCCS, Fermo, Italy


BACKGROUND: Switching is a “hot” topic and the main reasons for switching prior biologic agent are for a primary failure, a secondary failure or drug intolerance, patient’s dissatisfaction, physician decision. The aim of the study was to assess the optimization of the switching from a biologic agent to another.
METHODS: Five Dermatological Units have participated to PsOMarche working group have studied thirty-eight patients affected moderate to severe chronic plaque psoriasis at time 0 (patient recruitment at time of switching from biological therapy to another), 8 weeks (T8), 16 weeks (T16).
RESULTS: Twenty-eight males and 10 females were included in the study. At T0, 18 of 22 patients treated with etanercept had been switched to adalimumab and 4 to ustekinumab. Among 10 patients treated with adalimumab, 5 had been switched to ustekinumab, 2 to golimumab and 3 to certolizumab pegol. One patient treated with Infliximab and 5 patients treated with ustekinumab had been switched to adalimumab. Switching had been performed for primary inefficacy in 9 patients (23.6%) and a secondary failure was evidenced in 29 patients (73.4%). PASI75 was achieved in 53% and in 89.4% of patients after 8 weeks and 16 weeks of switching to the second biologic agent respectively; similarly, PsoDISK score significantly decreased at T8 and T16.
CONCLUSIONS: The experience of PsOMarche group have shown that the switching to a biologic agent to another is a valuable treatment choice in patients with moderate to severe psoriasis experiencing a treatment failure with one biologic therapy, leading to a good improvement in skin disease and in patient’s quality of life.

KEY WORDS: Psoriasis - Biological therapy - Biologic factors

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