Optimizing biologics for chronic plaque psoriasis: insights on non‐medical interruptions of IL‐17, IL‐12/23, and IL‐23 inhibitors

Summary Background and objectives Continuous biologic treatment is recommended for patients with psoriasis; however, treatment interruption in daily practice is inevitable. The impact of treatment interruption is difficult to study in a real‐world setting. In Taiwan, biologics are reimbursed by the National Health Insurance for moderate‐to‐severe psoriasis for a 2‐year course, followed by regulatory discontinuation. Thus, our study provides pragmatic data on the impact of the interruption of biologics treatment for non‐medical reasons on therapy effectiveness. Patients and methods This single‐center retrospective cohort study recruited patients who underwent two consecutive 2‐year courses of biologics between 2012 to 2021. Results A total of 192 treatment courses from 61 patients were analyzed, with secukinumab and ustekinumab being the most frequently administered biologics. Among patients who continued with the same biologic across two consecutive courses, the time to achieve PASI 75 was shorter during the first course compared to the second, while overall maintenance effects remained similar. Switching to a different biologic usually produced superior results in the second course of treatment. Conclusions Although the overall effectiveness after interruption and resumption of treatment with secukinumab or ustekinumab was comparable, the time to achieve PASI 75 was longer following an interruption. Continuous, uninterrupted treatment with a given biologic is therefore recommended whenever possible.