{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T15:16:57Z","timestamp":1788016617356,"version":"build-2784847793"},"reference-count":42,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:00:00Z","timestamp":1780099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:00:00Z","timestamp":1780099200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Discontinuation of biologic therapies in patients with psoriasis may occur for various reasons. Our study aims to evaluate the factors affecting relapse duration, clinical characteristics of patients experiencing relapses, and treatment responses in patients who discontinued biologic treatments.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Data from 121 patients with plaque psoriasis who discontinued biologic therapy were retrospectively analyzed. Linear and logistic regression analyses were used to evaluate factors influencing relapse duration and determinants of Psoriasis Area and Severity Index (PASI) 90 response after relapse, respectively.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The cumulative probability of remaining relapse\u2010free following biologic therapy discontinuation was 35.6%, 19%, 11.6%, and 9.1% at 6, 12, 18, and 24\u2009months, respectively. The classes of biologic therapies used at the time of treatment discontinuation, the baseline PASI score, the presence of a PASI 90 response at the time of discontinuation, and triggering factors were all found to be significant risk factors influencing relapse duration (\n p<\/jats:italic>\n \u2009=\u20090.001,\n p<\/jats:italic>\n \u2009=\u20090.027,\n p<\/jats:italic>\n \u2009=\u20090.001, and\n p<\/jats:italic>\n \u2009<\u20090.001, respectively). IL\u201023 inhibitors were associated with the longest relapse duration (38\u2009weeks), followed by IL\u201012\/23 inhibitor (21\u2009weeks), IL\u201017 inhibitors (17.5\u2009weeks), and TNF\u2010\u03b1 inhibitors (13.5\u2009weeks). Among the 80 psoriasis patients who restarted biologic therapy, the PASI 90 response rates for TNF\u2010\u03b1 inhibitors, IL\u201017 inhibitors, the IL\u201012\/23 inhibitor, and IL\u201023 inhibitors were 52.9%, 78.8%, 76.5%, and 92.3%, respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Prolonged relapse durations were associated with a low baseline PASI score, the presence of a PASI 90 response at discontinuation, the absence of triggering factors, and the use of IL\u201023 inhibitors.<\/jats:p>\n \n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ijd.70498","type":"journal-article","created":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T06:04:56Z","timestamp":1780207496000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Evaluation of Discontinuation and Re\u2010Initiation of Biologic Therapies in Psoriasis: Real\u2010World Data"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4061-8094","authenticated-orcid":false,"given":"Ahmet Taha","family":"Aydemir","sequence":"first","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine Ankara University Ankara Turkey"},{"name":"Department of Dermatology Yozgat City Hospital Yozgat Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2586-1136","authenticated-orcid":false,"given":"Nihal","family":"Kundakc\u0131","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine Ankara University Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,30]]},"reference":[{"issue":"4","key":"e_1_2_9_2_1","first-page":"278","article-title":"Diagnosis and Management of Psoriasis","volume":"63","author":"Kim W. 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D.","year":"2023","journal-title":"Journal of Dermatological Treatment"},{"issue":"3","key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1111\/jocd.15638","article-title":"Clinical Course of Psoriasis Patients That Discontinued Biologics During the COVID\u201019 Pandemic","volume":"22","author":"Topalo\u011flu Demir F.","year":"2023","journal-title":"Journal of Cosmetic Dermatology"},{"issue":"4","key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s40257-022-00679-y","article-title":"Time to Relapse After Discontinuing Systemic Treatment for Psoriasis: A Systematic Review","volume":"23","author":"Masson Regnault M.","year":"2022","journal-title":"American Journal of Clinical Dermatology"},{"issue":"2","key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1111\/j.1365-2133.2010.10139.x","article-title":"Adalimumab for Moderate to Severe Chronic Plaque Psoriasis: Efficacy and Safety of Retreatment and Disease Recurrence Following Withdrawal From Therapy","volume":"164","author":"Papp K.","year":"2011","journal-title":"British Journal of Dermatology"},{"issue":"3","key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1007\/s13555-019-0310-5","article-title":"Remission Duration and Long\u2010Term Outcomes in Patients With Moderate\u2010To\u2010Severe Psoriasis Treated by Biologics or Tofacitinib in Controlled Clinical Trials: A 15\u2010Year Single\u2010Center Experience","volume":"9","author":"Huang Y. W.","year":"2019","journal-title":"Dermatology and Therapy"},{"issue":"1","key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00403-010-1080-1","article-title":"Definition of Treatment Goals for Moderate to Severe Psoriasis: A European Consensus","volume":"303","author":"Mrowietz U.","year":"2011","journal-title":"Archives of Dermatological Research"},{"issue":"11","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"2461","DOI":"10.1111\/jdv.16915","article-title":"EuroGuiDerm Guideline on the Systemic Treatment of Psoriasis Vulgaris\u2014Part 1: Treatment and Monitoring Recommendations","volume":"34","author":"Nast A.","year":"2020","journal-title":"Journal of the European Academy of Dermatology and Venereology"},{"issue":"3","key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1080\/09546630310013360","article-title":"Psoriasis Disease Severity Measures: Comparing Efficacy of Treatments for Severe Psoriasis","volume":"14","author":"Weisman S.","year":"2003","journal-title":"Journal of Dermatological Treatment"},{"issue":"3","key":"e_1_2_9_13_1","article-title":"The Relapse of Psoriasis: Mechanisms and Mysteries","volume":"2","author":"Tian D.","year":"2022","journal-title":"Journal of Investigative Dermatology Innovations"},{"issue":"1","key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1001\/archderm.141.1.82","article-title":"Definitions of Measures of Effect Duration for Psoriasis Treatments","volume":"141","author":"Gordon K. 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Y.","year":"2024","journal-title":"Dermatology and Therapy"},{"issue":"3","key":"e_1_2_9_17_1","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1111\/jdv.15292","article-title":"Long\u2010Term Efficacy and Safety Results From an Open\u2010Label Phase III Study (UNCOVER\u2010J) in Japanese Plaque Psoriasis Patients: Impact of Treatment Withdrawal and Retreatment of Ixekizumab","volume":"33","author":"Umezawa Y.","year":"2019","journal-title":"Journal of the European Academy of Dermatology and Venereology"},{"issue":"1","key":"e_1_2_9_18_1","doi-asserted-by":"crossref","first-page":"e65","DOI":"10.1111\/jdv.16809","article-title":"Maintenance of Response Following Discontinuation of Guselkumab and Secukinumab in Spanish Patients Who Participated in the ECLIPSE Study","volume":"35","author":"Rivera R.","year":"2021","journal-title":"Journal of the European Academy of Dermatology and Venereology"},{"issue":"6","key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1111\/bjd.18225","article-title":"Relapse of Psoriasis in Patients Who Asked to Discontinue Etanercept After Achieving a Stable Clinical Remission","volume":"181","author":"Bellinato F.","year":"2019","journal-title":"British Journal of Dermatology"},{"issue":"1","key":"e_1_2_9_20_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.jaad.2019.01.035","article-title":"Predictors of Time to Relapse Following Ustekinumab Withdrawal in Patients With Psoriasis Who Had Responded to Therapy: An 8\u2010Year Multicenter Study","volume":"88","author":"Chiu H. Y.","year":"2023","journal-title":"Journal of the American Academy of Dermatology"},{"issue":"6","key":"e_1_2_9_21_1","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1007\/s40257-024-00887-8","article-title":"Predicting the Time to Relapse Following Withdrawal From Different Biologics in Patients With Psoriasis Who Responded to Therapy: A 12\u2010Year Multicenter Cohort Study","volume":"25","author":"Huang Y. H.","year":"2024","journal-title":"American Journal of Clinical Dermatology"},{"issue":"3","key":"e_1_2_9_22_1","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1111\/bjd.15656","article-title":"Secukinumab Re\u2010Initiation Achieves Regain of High Response Levels in Patients Who Interrupt Treatment for Moderate to Severe Plaque Psoriasis","volume":"177","author":"Blauvelt A.","year":"2017","journal-title":"British Journal of Dermatology"},{"issue":"2","key":"e_1_2_9_23_1","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1177\/247553031016a00205","article-title":"How Long Does the Benefit of Biologics Last? An Update on Time to Relapse and Potential for Rebound of Biologic Agents for Psoriasis","volume":"16","author":"Kamaria M.","year":"2010","journal-title":"Psoriasis Forum"},{"issue":"7","key":"e_1_2_9_24_1","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1016\/j.jid.2021.01.005","article-title":"Differential Changes in Inflammatory Mononuclear Phagocyte and T\u2010Cell Profiles Within Psoriatic Skin During Treatment With Guselkumab vs Secukinumab","volume":"141","author":"Mehta H.","year":"2021","journal-title":"Journal of Investigative Dermatology"},{"issue":"1","key":"e_1_2_9_25_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.5114\/ada.2021.113125","article-title":"The Effect of Therapy on TRM in Psoriatic Lesions","volume":"39","author":"Owczarczyk\u2010Saczonek A.","year":"2022","journal-title":"Postepy Dermatologii I Alergologii"},{"issue":"77","key":"e_1_2_9_26_1","doi-asserted-by":"crossref","DOI":"10.1126\/sciimmunol.abq3254","article-title":"Local IL\u201023 Is Required for Proliferation and Retention of Skin\u2010Resident Memory T(H)17 Cells","volume":"7","author":"Whitley S. 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B.","year":"2021","journal-title":"Journal of the European Academy of Dermatology and Venereology"},{"issue":"1","key":"e_1_2_9_31_1","doi-asserted-by":"crossref","DOI":"10.1080\/09546634.2025.2480743","article-title":"Personalized Prediction of Psoriasis Relapse Post\u2010Biologic Discontinuation: A Machine Learning\u2010Driven Population Cohort Study","volume":"36","author":"Huang S.","year":"2025","journal-title":"Journal of Dermatological Treatment"},{"issue":"8","key":"e_1_2_9_32_1","article-title":"Systemic Pharmacological Treatments for Chronic Plaque Psoriasis: A Network Meta\u2010Analysis","volume":"8","author":"Sbidian E.","year":"2025","journal-title":"Cochrane Database of Systematic Reviews"},{"issue":"4","key":"e_1_2_9_33_1","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1111\/jdv.12817","article-title":"PASI90 Response: The New Standard in Therapeutic Efficacy for Psoriasis","volume":"29","author":"Puig L.","year":"2015","journal-title":"Journal of the European Academy of Dermatology and Venereology"},{"issue":"9","key":"e_1_2_9_34_1","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1111\/jdv.14387","article-title":"Early Relapse of Psoriasis After Stopping Brodalumab: A Retrospective Cohort Study in 77 Patients","volume":"31","author":"Masson Regnault M.","year":"2017","journal-title":"Journal of the European Academy of Dermatology and Venereology"},{"issue":"1","key":"e_1_2_9_35_1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.jdcr.2017.06.026","article-title":"Erythrodermic Psoriasis After Discontinuation of Ixekizumab","volume":"4","author":"Potter K. A.","year":"2018","journal-title":"JAAD Case Reports"},{"issue":"1","key":"e_1_2_9_36_1","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s13075-023-03045-3","article-title":"Factors Associated With Discontinuation of Biologics in Patients With Inflammatory Arthritis in Remission: Data From the BIOBADASER Registry","volume":"25","author":"Valero M.","year":"2023","journal-title":"Arthritis Research & Therapy"},{"issue":"5","key":"e_1_2_9_37_1","doi-asserted-by":"crossref","DOI":"10.1111\/dth.15052","article-title":"Real\u2010World Evidence on Time to Relapse of Plaque Psoriasis After Discontinuation of Biologic Treatment in Poland","volume":"34","author":"Owczarek W.","year":"2021","journal-title":"Dermatologic Therapy"},{"issue":"1","key":"e_1_2_9_38_1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.jaad.2015.04.011","article-title":"Secukinumab Retreatment\u2010As\u2010Needed Versus Fixed\u2010Interval Maintenance Regimen for Moderate to Severe Plaque Psoriasis: A Randomized, Double\u2010Blind, Noninferiority Trial (SCULPTURE)","volume":"73","author":"Mrowietz U.","year":"2015","journal-title":"Journal of the American Academy of Dermatology"},{"issue":"1","key":"e_1_2_9_39_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jaad.2006.07.017","article-title":"A Randomized Comparison of Continuous vs. Intermittent Infliximab Maintenance Regimens Over 1 Year in the Treatment of Moderate\u2010To\u2010Severe Plaque Psoriasis","volume":"56","author":"Menter A.","year":"2007","journal-title":"Journal of the American Academy of Dermatology"},{"key":"e_1_2_9_40_1","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1001\/jamadermatol.2025.2714","article-title":"Biopharmaceutical Switching in Psoriasis Treatment: A Systematic Review and Meta\u2010Analysis","volume":"161","author":"Zhang M.","year":"2025","journal-title":"JAMA Dermatology"},{"issue":"5","key":"e_1_2_9_41_1","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1080\/17512433.2020.1767590","article-title":"Switching Biologics in Psoriasis\u2014Practical Guidance and Evidence to Support","volume":"13","author":"Tsai Y. 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