Allungamento del tempo di somministrazione dei farmaci biologici in pazienti con psoriasi stabilizzata come raggiungimento della "sensazione di guarigione": studio multicentrico

Psoriasis is a cutaneous chronic inflammatory disease which can be classified in mild, moderate or severe, according with the skin involvement. For the severe forms, biological therapies have been recently introduced. These therapies often cause a complete clearance of the skin lesions, but they have specific and rigid dose administration regimens. Recently, some studies have proposed a dose tapering to improve the patient's quality of life and reduce the health costs. We considered in this study 199 patients treated with one biological therapy among infliximab, etanercept, adalimumab or ustekinumab, from January 2005 through June 2018. Of them, 96 reached a complete clearance of the lesions (PASI100) maintained for at least 12 months. In this group, we elongated the administration period of the used biologic and we administered a questionnaire about the “healing sensation”. In the other 103 patients, who did not reach the PASI100, we maintained the therapy at the standard dose. We also evaluated the percentage of relapses among the two groups and the association between the incidence of relapses and hypertension, diabetes, psoriatic arthritis or smoking habits. The difference in terms of relapses between the two groups appeared negligible (p-value 0.445) while hypertension has been related to a higher percentage of psoriasis recurrence in both groups. In the group of dose tapering, most patients (61,70%) reported high satisfaction and “healing sensation” after the dose tapering of the biologic. Biological therapies cause often a good therapeutic response or, in most cases, a complete remission of the disease. Our study demonstrated that a dose tapering of biologics maintain good results in terms of efficacy and it is well accepted by the psoriatic patients. More studies are needed to evaluate the long-term efficacy of these new therapeutic regimens of biologics and to study the newly introduced parameter of “healing sensation”.