Clinical improvement and satisfaction with biologic therapy in patients with severe plaque psoriasis: results of a European cross-sectional observational study

Background: Efficacy of biologic therapies for psoriasis has been demonstrated in randomized trials, but effectiveness in real-world settings has yet to be fully determined. Objective: To compare clinical improvement and treatment satisfaction with biologic versus other therapies in patients with plaque psoriasis. Methods: European dermatologists recruited psoriasis patients into an observational study. Dermatologists reported disease severity before and after starting current therapy; dermatologists and patients reported treatment satisfaction. Results: These analyses included 2151 patients: topicals, n = 453; phototherapy, n = 666; conventional systemics, n = 683; biologics, n = 349. The percentage with severe disease declined from 70% before to 15% after biologics, a significantly greater decline than other therapies: topicals, 22-10%; phototherapy, 20-11%; conventional systemics, 49-15% (all p <= 0.03). Significantly more patients (59%) receiving biologics were satisfied with treatment versus topicals (45%), phototherapy (34%), or conventional systemics (50%) (all p < 0.001). Significantly more dermatologists were satisfied with biologics (60%) versus topicals (35%), phototherapy (26%), or conventional systemics (42%) (all p < 0.001). Conclusions: In this study, more patients receiving biologic therapies improved from severe to moderate or mild psoriasis than patients on other treatments. More patients with plaque psoriasis and their dermatologists were satisfied with biologics than any other treatment.