{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:57:12Z","timestamp":1792803432337,"version":"4.5.0"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T00:00:00Z","timestamp":1673395200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Since psoriasis is a chronic disease, it is not recommended to discontinue the treatment agents used. However, in real life, the treatment of psoriasis patients may be interrupted for various reasons. During the pandemic period, the treatment of many patients was also interrupted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate relapse and clinical worsening in psoriasis patients whose biological therapy was interrupted during the pandemic and reveal associated factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study included patients aged \u226518\u2009years, who were followed up with moderate and severe chronic psoriasis controlled by the last biological agent [Psoriasis Area Severity Index (PASI) 75 response achieved] but had to discontinue their treatment during the pandemic. The patients' demographic and clinical characteristics, clinical course after the discontinuation of these agents, presence of clinical worsening, and relapse were evaluated. Risk factors were analyzed with the logistic regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 169 patients, with a mean age of 47.3\u2009\u00b1\u200914.5 (18\u201387) years. The mean biologics\u2010free time was 18.2\u2009\u00b1\u200912.3 (2\u201356) weeks. Clinical worsening was detected in 41.4% and relapse in 48.5% of the patients. The significant risk factors for clinical worsening and relapse in both univariate and multivariate analyses were alcohol use during the biologics\u2010free period, total time off biologics, and the presence of an additional triggering factor. The use of secukinumab and ustekinumab was found to be a protective factor against clinical worsening in multivariate analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>As the biologics\u2010free period is prolonged, the likelihood of clinical worsening and relapse increases, therefore, we do not recommend discontinuing biological agents.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.15638","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T22:53:00Z","timestamp":1673477580000},"page":"722-731","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Clinical course of psoriasis patients that discontinued biologics during the <scp>COVID<\/scp>\u201019 pandemic"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2049-1316","authenticated-orcid":false,"given":"Filiz","family":"Topalo\u011flu\u00a0Demir","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology, Faculty of Medicine Istanbul Medipol University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alg\u00fcn","family":"Polat\u00a0Ekinci","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Istanbul Faculty of Medicine Istanbul University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sema","family":"Aytekin","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Faculty of Medicine Tekirdag Namik Kemal University  Tekirdag Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeynep","family":"Topkarc\u0131","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital Health Sciences University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4347-3134","authenticated-orcid":false,"given":"Melek","family":"Aslan\u00a0Kay\u0131ran","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Goztepe Training and Research Hospital Istanbul Medeniyet University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9995-2543","authenticated-orcid":false,"given":"Tu\u011fba","family":"\u00d6zk\u00f6k\u00a0Akbulut","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Haseki Training and Research Hospital Health Sciences University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130lteri\u015f","family":"O\u011fuz\u00a0Topal","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Prof. Dr. Cemil Tascioglu City Hospital Health Sciences University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sezgi","family":"Sar\u0131kaya\u00a0Solak","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Faculty of Medicine Trakya University  Edirne Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asude","family":"Kara\u00a0Polat","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Istanbul Training and Research Hospital Health Sciences University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ay\u015fe\u00a0Serap","family":"Karada\u011f","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Memorial Atasehir Hospital Istanbul Arel University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.06.056"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2020.03.033"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2019.4029"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2019.01.035"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2020.07.021"},{"key":"e_1_2_9_7_1","first-page":"1","article-title":"The impact of COVID\u201019 pandemic on psoriasis patients, and their immunosuppressive 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