Drug Survival of Biologic Therapy for Moderate‐to‐Severe Psoriasis in a Latin American Specialized Psoriasis Center: A 7‐Year Experience
Laura I. Vallejo-Londoño, Sneider Torres-Soto, Valentina Naranjo-Tobón, Sebastián Bedoya-Mejía, Juliana Madrigal-Cadavid, Susana Chiquito-García, Ángela Londoño-GarcíaBackground
Drug survival integrates effectiveness, safety, and access in routine psoriasis care, yet real‐world Latin American data are scarce. We assessed drug survival and explanatory factors of discontinuation among bio‐naïve adults with moderate‐to‐severe psoriasis in Colombia.
Methods
We conducted a retrospective cohort study using secondary electronic health record data from a multidisciplinary clinic in Medellín, Colombia (CLIPSO) from January 2018 to December 2024. Eligible adults met at least one severity criterion (PASI ≥ 10, BSA ≥ 10, or DLQI ≥ 10), initiated a first biologic, and had ≥ 3 months of treatment. Drug survival was the time from initiation to discontinuation for any reason. Records with > 60% missing data underwent targeted chart review to verify key variables. Kaplan–Meier curves (log‐rank) and Cox proportional hazards models were used.
Results
The cohort included 1098 patients (48.8% women); 30.1% discontinued therapy. Therapeutic failure was the leading reason (58.2%), whereas adverse events were less frequently reported (11.2%). Drug survival declined to ∼50% at 60 months and ∼43% by 80 months. In multivariable analyses, adalimumab showed higher discontinuation risk (aHR = 1.36; 95% CI: 1.0001–1.84), whereas risankizumab (aHR = 0.41; 95% CI: 0.21–0.80), guselkumab (aHR = 0.42; 95% CI: 0.26–0.68), ixekizumab (aHR = 0.59; 95% CI: 0.41–0.85), and secukinumab (aHR = 0.67; 95% CI 0.47–0.97) showed better persistence. The presence of a high burden of comorbidities increased risk (aHR = 1.71; 95% CI: 1.12–2.63), whereas prior systemic therapy was protective (aHR = 0.45; 95% CI: 0.28–0.72).
Conclusions
Drug survival differed across biologics in this Colombian real‐world cohort, with interleukin‐23 and interleukin‐17 inhibitors demonstrating greater persistence in both bivariate and multivariable models and comorbidity burden identifying patients at higher risk of discontinuation.