Response to fumaric acid esters for plaque type psoriasis in real-world practice is largely independent of patient characteristics at baseline - a multivariable regression analysis from the German Psoriasis Registry PsoBest

Objectives Fumaric acid esters (FAEs) are a well-established treatment option for long-term therapy of moderate to severe plaque psoriasis. This study examines effectiveness of FAEs for the treatment of plaque psoriasis in real-world practice at 12 months and if patient characteristics affect the odds of clinical response. Methods A descriptive, multivariable logistic regression analysis was conducted in a cohort drawn from the German registry PsoBest. Baseline patient characteristics were assessed as potential treatment effect modifiers. Results 444 patients (mean age 47.0 years, 39.0% female) were eligible for response analysis using nonresponder imputation at month 12. Of these, 39.6% achieved clinical response, i.e. Psoriasis Area and Severity Index (PASI) <= 3 or skin clearance. In logistic regression analysis (R-2 = 0.114), only baseline PASI was a significant factor: patients with PASI < 10 had a 4 times higher odds (p <= .001, OR 4.088), patients with PASI of 10-20 a twofold higher odds of response (p <= .044, OR 1.961) compared to those with PASI > 20. Neither sex, age, body weight, disease duration, comorbidity nor pretreatment had an impact on the odds of response (p > .05). Conclusions FAEs showed a favorable response at 12 months, largely independent of patient characteristics.

Automated summary

This study examines the effectiveness of fumaric acid esters (FAEs) for the treatment of plaque psoriasis in real-world practice. The results show that FAEs have a favorable response at 12 months, largely independent of patient characteristics. The baseline psoriasis area and severity index (PASI) is the only significant factor affecting the odds of response.