{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:09:49Z","timestamp":1792026589935,"version":"4.4.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T00:00:00Z","timestamp":1665187200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Psoriasis and Psoriatic Arthritis"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite their impressive efficacy in phase 3 trials, biologic agents for psoriasis (PsO) may lose efficacy over time. The factors associated with loss of efficacy have yet to be fully elucidated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to identify factors associated with PsO patients using multiple biologics in comparison to patients who used 1 biologic. We also reviewed the literature comparing the survival of different biologic agents for PsO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We examined clinical data from 222 psoriasis patients at the University of California San Francisco, of whom 51 reported use of 3 or more biologics and of whom 171 reported use of only a single biologic agent at the time of enrollment into a research database from 2006-2020. This study was IRB-approved at UCSF (#10-02830) and all subjects provided written informed consent. We performed univariate and multivariate regression analysis to identify significant demographic features, clinical features, and co-morbidities associated with multi-biologic use. We performed a literature review of studies comparing psoriasis biologic survival at 1, 2, and 5\u00a0years and factors associated with single biologic failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In univariate analysis, duration of PsO, initial presentation of PsO on the gluteal cleft, erythrodermic psoriasis, and acne were associated with using 3 or more biologics. In multivariate analysis, duration of PsO, erythrodermic psoriasis, and acne remained significant. Our review of biologic survival revealed differences according to biologic class.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We identified novel factors associated with multi-biologic use in PsO. Further studies in this area are needed to achieve a precision medicine approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/24755303221131259","type":"journal-article","created":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T11:26:07Z","timestamp":1665228367000},"page":"11-18","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Factors Associated with Multi-Biologic Use in Psoriasis Patients at an Academic Medical Center and Review of Biologic Survival"],"prefix":"10.1177","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3005-6529","authenticated-orcid":false,"given":"Edward","family":"Hadeler","sequence":"first","affiliation":[{"name":"Department of Dermatology, University of California, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sugandh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of California, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8327-3279","authenticated-orcid":false,"given":"Samuel","family":"Yeroushalmi","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of California, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of California, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Wallace","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Mosca","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of California, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Bartholomew","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of California, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mimi","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of California, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwa","family":"Hakimi","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of California, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soumya","family":"Reddy","sequence":"additional","affiliation":[{"name":"New York University Langone Health, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Scher","sequence":"additional","affiliation":[{"name":"New York University Langone Health, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Bhutani","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of California, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6468-0397","authenticated-orcid":false,"given":"George","family":"Gondo","sequence":"additional","affiliation":[{"name":"National Psoriasis Foundation, Portland, OR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Southern California Keck School of Medicine, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9987-567X","authenticated-orcid":false,"given":"Stacie","family":"Bell","sequence":"additional","affiliation":[{"name":"Opsis Health\/Global Nutrition Project, Golden, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7883-6439","authenticated-orcid":false,"given":"Wilson","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of California, San Francisco, CA, 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