{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T05:50:36Z","timestamp":1746510636922,"version":"3.32.0"},"reference-count":15,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T00:00:00Z","timestamp":1721606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust J Dermatology"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The advent of novel biologics has led to an increase in biologic\u2010switching as patients and clinicians pursue improved clinical outcomes. However, guidance on treatment sequencing in an Australian setting is sparse. This study examines the patterns of care across two tertiary centres in Australia and characterizes the factors contributing to biologic\u2010switching.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study of patients who attended the outpatient Dermatology biologic clinics across two tertiary hospitals was conducted. Data on treatment sequencing and patients' PASI at every visit from April 2006 to December 2020 were collected. Patterns of biologic\u2010switching were examined. The speed of treatment response for each biologic was determined by the time to achieve PASI\u201090 and \u2010100 for each treatment course.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 440 treatment courses were analysed. Ustekinumab and adalimumab were the most frequently prescribed first\u2010line biologics. The highest proportion of biologic\u2010switching was observed among patients on TNF\u2010\u03b1 inhibitors (63.8%). After 2015, more patients were prescribed IL\u201012\/23 and IL\u201017 inhibitors in favour of TNF\u2010\u03b1 inhibitors. IL\u201017 inhibitors demonstrated the most rapid treatment response and low PASI scores relative to other biologics. Patients who did not switch biologics had lower rates of psoriatic arthritis and lower BMI, compared to patients who switched biologics. The median PASI on discontinuation generally exceeded 3.0, while on continuation, it was less than 1.2, reflecting patients' and clinicians' thresholds for biologic\u2010switching.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study demonstrates an increased uptake of more novel biologics as they become available, due to improved safety profiles and clinical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajd.14350","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T04:59:21Z","timestamp":1721710761000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Biologic treatment sequences in moderate\u2010to\u2010severe psoriasis"],"prefix":"10.1111","volume":"65","author":[{"given":"Samantha","family":"Ting","sequence":"first","affiliation":[{"name":"The University of Sydney  Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Lowe","sequence":"additional","affiliation":[{"name":"The University of Sydney  Camperdown New South Wales Australia"},{"name":"Department of Dermatology Royal Prince Alfred Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annika","family":"Smith","sequence":"additional","affiliation":[{"name":"The University of Sydney  Camperdown New South Wales Australia"},{"name":"Department of Dermatology Westmead Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4882-1564","authenticated-orcid":false,"given":"Pablo","family":"Fern\u00e1ndez\u2010Pe\u00f1as","sequence":"additional","affiliation":[{"name":"The University of Sydney  Camperdown New South Wales Australia"},{"name":"Department of Dermatology Westmead Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.16072"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/dth.12267"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40261-017-0603-3"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-014-0130-5"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.18409"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.15920"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2016.02.275"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555-019-00337-y"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/09546630903085328"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.143.9.1175"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00403-015-1613-8"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2011.04065.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-215386"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2020.07.085"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14630"}],"container-title":["Australasian Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajd.14350","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T13:11:20Z","timestamp":1735909880000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ajd.14350"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,22]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1111\/ajd.14350"],"URL":"https:\/\/doi.org\/10.1111\/ajd.14350","archive":["Portico"],"relation":{},"ISSN":["0004-8380","1440-0960"],"issn-type":[{"type":"print","value":"0004-8380"},{"type":"electronic","value":"1440-0960"}],"subject":[],"published":{"date-parts":[[2024,7,22]]},"assertion":[{"value":"2024-05-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}