{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T19:52:47Z","timestamp":1785786767763,"version":"3.56.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T00:00:00Z","timestamp":1689897600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100005897","name":"French Society of Dermatology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005897","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Many biologics are available for psoriasis and have been compared in real-life studies based on their persistence (i.e. time between initiation and discontinuation). However, after first-line biologic failure, data are lacking on the choice of second-line biologic among the four available classes [tumour necrosis factor inhibitors (TNFi); interleukin (IL)-12\/IL-23 inhibitor (IL-12\/IL-23i); IL-17 inhibitors (IL-17i); and IL-23 inhibitors (IL-23i)].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To compare the long-term persistence of available second-line biologics in psoriasis according to prior exposure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This nationwide cohort study involved the administrative healthcare database of the French health insurance scheme linked to a hospital discharge database. Participants were adults with psoriasis, defined as having at least two prescriptions of a topical vitamin D derivative within a 2-year period, with initiation of a second-line biologic between 1 January 2015 and 31 December 2021. We included patients who initiated a second-line biologic directly after first-line discontinuation (i.e. without a \u2018washout\u2019 period). The end of follow-up was 30 June 2022. Discontinuation was defined as &amp;gt; 90\u2005days without filling a prescription for the same treatment after the period covered by the previous prescription. Comparison of persistence by biologic class involved using propensity score-weighted Cox models (inverse probability treatment weighting) and adjustment of specific systemic nonbiologics (time-dependent variables).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 8693 patients [mean (SD) age 50 (14) years; 50.5% male]; 2824 (32.5%) started TNFi, 1561 (18.0%) IL-12\/IL-23i, 2707 (31.1%) IL-17i and 1601 (18.4%) IL-23i. Overall, 1- and 3-year persistence rates were 60% and 30%, respectively. After weighting and adjustment, persistence was longer with IL-12\/IL-23i [weighted hazard ratio (HRw) 0.68, 95% confidence interval (CI) 0.62\u20130.76)], IL-17i (HRw 0.70, 95% CI 0.64\u20130.78) and IL-23i (HRw 0.36, 95% CI 0.31\u20130.42) than TNFi, except after first-line IL-17i treatment, with no difference between IL-12\/IL-23i, IL-17i and TNFi second-line persistence. Persistence was longer with IL-23i as a second-line treatment than IL-12\/IL-23i (HRw 0.53, 95% CI 0.44\u20130.63) and IL-17i (HRw 0.51, 95% CI 0.44\u20130.60), regardless of first-line treatment, with no difference seen between IL-12\/IL-23i and IL-17i (HRw 0.97, 95% CI 0.87\u20131.09).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This real-life study suggests the longer persistence of IL-23i than TNFi, IL-17i and IL-12\/IL-23i as second-line treatment for psoriasis. Persistence rates for all biologics remained low at 3\u2005years.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjd\/ljad248","type":"journal-article","created":{"date-parts":[[2023,7,22]],"date-time":"2023-07-22T01:30:41Z","timestamp":1689989441000},"page":"561-568","source":"Crossref","is-referenced-by-count":7,"title":["Persistence of second-line biologics in psoriasis after first-line biologic failure: a nationwide cohort study from\u00a0the French health insurance database (SNDS)"],"prefix":"10.1093","volume":"189","author":[{"given":"Clarisse","family":"Marcombes","sequence":"first","affiliation":[{"name":"EpiDermE, Paris Est Cr\u00e9teil University , Cr\u00e9teil , France"},{"name":"EPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products and the French National Health Insurance , Saint Denis , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laetitia","family":"Penso","sequence":"additional","affiliation":[{"name":"EpiDermE, Paris Est Cr\u00e9teil University , Cr\u00e9teil , France"},{"name":"EPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products and the French National Health Insurance , Saint Denis , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Weill","sequence":"additional","affiliation":[{"name":"EPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products and the French National Health Insurance , Saint Denis , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemary","family":"Dray-Spira","sequence":"additional","affiliation":[{"name":"EPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products and the French National Health Insurance , Saint Denis , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Zureik","sequence":"additional","affiliation":[{"name":"EPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products and the French National Health Insurance , Saint Denis , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1267-5270","authenticated-orcid":false,"given":"Emilie","family":"Sbidian","sequence":"additional","affiliation":[{"name":"EpiDermE, Paris Est Cr\u00e9teil University , Cr\u00e9teil , France"},{"name":"EPI-PHARE Scientific Interest Group in Epidemiology of Health Products from the French National Agency for the Safety of Medicines and Health Products and the French National Health Insurance , Saint Denis , France"},{"name":"Inserm, Centre d\u2019investigation clinique 1430 , H\u00f4pital Henri Mondor, Creteil , France"},{"name":"Department of Dermatology, AP-HP, H\u00f4pital Henri Mondor , Cr\u00e9teil , France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,7,21]]},"reference":[{"key":"2024090209465971700_ljad248-B1","doi-asserted-by":"crossref","first-page":"m1590","DOI":"10.1136\/bmj.m1590","article-title":"National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study","volume":"369","author":"Parisi","year":"2020","journal-title":"BMJ"},{"key":"2024090209465971700_ljad248-B2","first-page":"CD011535","article-title":"Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis","volume":"5","author":"Sbidian","year":"2022","journal-title":"Cochrane Database Syst 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