{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T21:36:37Z","timestamp":1769549797904,"version":"3.49.0"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T00:00:00Z","timestamp":1721865600000},"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":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>It is unknown whether the pre\u2010biologic treatment journey affects subsequent biologic drug survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the potential impact of a complex treatment journey on subsequent biologic drug survival in patients with psoriasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study utilized longitudinal data from Danish national registries and included all patients who, for the first time, initiated a biological treatment for psoriasis. Maximum follow\u2010up was 5\u2009years and patients were included from 1 January 2010 to 30 June 2021. The study used three definitions of exposure to a complex treatment journey and the following conventional systemic treatments: acitretin, cyclosporine, dimethyl fumarate and methotrexate. The first definition was the cumulative number of treatment series. The second definition comprised the number of unique treatments. The third definition was time from the first conventional systemic treatment to biological therapy. Drug survival for the three definitions were illustrated using Kaplan\u2013Meier curves and compared using log\u2010rank test. The sensitivity analysis largely confirmed these findings by grouping patients according to pharmacotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2496 patients were included in the study, with 1380 (55.3%) receiving adalimumab, 608 (24.4%) receiving ustekinumab, 271 (10.9%) receiving secukinumab, 166 (6.7%) receiving etanercept and 71 (2.8%) receiving infliximab. The mean age at initiation of biologics was 43.6\u2009years (standard deviation (SD) 15.2\u2009years), and most patients were male (62.9%). During the follow\u2010up of 5477 patient years, 1953 patients (78.2%) reached the main endpoint of discontinuation. Using a log\u2010rank test, the probability of remaining on treatment was unaffected by the three definitions of complexity of the treatment journey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>None of the three exposures used to assess the complexity of the pre\u2010biologic treatment journey appeared to impact drug survival. As long as patients experience adequate disease control, these results suggest that conventional systemic treatment do not negatively impact the drug survival of subsequent biologics.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.20259","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T06:59:41Z","timestamp":1721890781000},"page":"1315-1323","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of the pre\u2010biologic treatment journey on biologic drug survival in psoriasis: A nationwide cohort study"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3984-023X","authenticated-orcid":false,"given":"David","family":"Thein","sequence":"first","affiliation":[{"name":"Department of Dermatology, Bispebjerg Hospital University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1562-8568","authenticated-orcid":false,"given":"Mia\u2010Louise","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Bispebjerg Hospital University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9914-1545","authenticated-orcid":false,"given":"Julia\u2010Tatjana","family":"Maul","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Z\u00fcrich  Z\u00fcrich Switzerland"},{"name":"Faculty of Medicine University of Zurich  Z\u00fcrich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4838-300X","authenticated-orcid":false,"given":"Simon Francis","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Bispebjerg Hospital University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Biomedical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3770-1743","authenticated-orcid":false,"given":"Jacob P.","family":"Thyssen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Bispebjerg Hospital University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8257-1816","authenticated-orcid":false,"given":"Alexander","family":"Egeberg","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Bispebjerg Hospital University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,25]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-028116"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1590"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2021.2007"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.15252"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2021.0734"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jvc2.63"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21051690"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2020.625755"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S179083"},{"key":"e_1_2_13_11_1","unstructured":"SKS Klassifikationer \u2010 Sundhedsdatastyrelsen [Internet]. 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