Clinical predictors of non-response to any tumor necrosis factor (TNF) blockers: a retrospective study

Abstract

The data showed that the majority of non-responder patients were smokers, overweight or obese and had a high baseline PASI score. Concomitant arthritis was not significantly associated with non-response.

A multicenter, prospective, observational study examining the impact of risk factors, such as BMI and waist circumference, on quality of life improvement and clinical response in moderate‐to‐severe plaque‐type psoriasis patients treated with infliximab in routine care settings of Greece

“…In agreement with other studies with biologic therapies, PASI 75 response attainment was not found to be associated with smoking status, alcohol consumption and age at disease onset, although smoking at initiation of anti‐TNFα therapy has been reported as a predictor of non‐response elsewhere . The only identified negative predictor of PASI 75 response attainment was the presence of comorbidities, supported by reports linking high comorbidity burden with psoriasis disease severity as well as with treatment failure with biologics …”

“…Similarly to the results of our study, baseline obesity was not found to be associated with infliximab's response attainment rates in the retrospective study conducted in Spain . Yet, several other studies have reported high BMI to be a negative predictor of response to biologics (including infliximab) . Interestingly, while an association of BMI with drug survival to biologics (a commonly used indicator of treatment effectiveness) in moderate‐to‐severe plaque psoriasis patients has been identified in the retrospective ORBIT study, and in the BIOBADADERM Registry, it should be noted that in another study identifying BMI to be a predictor of drug survival, this factor was not found to be associated with clinical response, cautioning against universal extrapolation of predictors of drug survival to predictors of clinical response.…”

“…Additionally, there is only limited data generated in routine care settings of Greece shedding light on factors that may influence infliximab's clinical response and its impact on the health‐related QoL (HRQoL). Previous studies have indicated that apart from obesity, smoking, alcohol consumption and female gender are negatively associated with clinical response and drug survival of biologic therapies for psoriasis, but findings are inconsistent . Under this perspective, this observational prospective study aimed to examine the impact of age at disease onset, BMI and WC on disease severity of patients with moderate‐to‐severe plaque psoriasis, as well as to examine potential predictors of clinical response attainment and the impact of infliximab on the patients’ HRQoL as measured by the skin‐specific dermatology quality of life index (DLQI) instrument, in moderate‐to‐severe plaque psoriasis patients treated with infliximab in the routine care of Greece.…”

Differential Drug Survival of Biologic Therapies for the Treatment of Psoriasis: A Prospective Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR)

“…However, the differential biologic survival did not change when the analysis was restricted to those patients < 100kgs (results not shown). Consistent with previous studies showing poor treatment response for TNFIs in psoriasis patients who were smokers, we found that being a current smoker was a predictor for overall discontinuation and for discontinuation due to ineffectiveness (Di Lernia et al, 2014), while being an ex-smoker did not predict for discontinuation, suggesting that an active smoking status could affect the effectiveness of a biologic therapy.…”

Some clinical factors affecting quality of the response to ustekinumab for psoriasis

“…In anti‐TNF‐α treatments for patients with rheumatoid arthritis, a lower response rate in cases with smokers was observed . Also, smoking was associated with non‐response to anti‐TNF‐α treatment in patients with psoriasis . Regarding previous treatments, narrow‐band UVB did not influence the efficacy of ustekinumab, the patients who had been treated with other biologic agents showed a lower response to ustekinumab.…”