ArticleDermatology and therapy2026
Impact of Biologic Treatment Duration on Drug-Free Remission in Moderate-to-Severe Psoriasis: A Retrospective Cohort Study.
Article in Dermatology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionPsoriasis is a chronic inflammatory disease that often requires long-term treatment. However, treatment interruption is common. Although several predictors of drug-free remission (DFR) have been reported, the impact of treatment duration remains unclear. In Taiwan, biologics were reimbursed for up to 2.5 years, with re-treatment initiated after relapse. This study compared DFR between reimbursed patients and those enrolled in phase III pivotal trials, where treatment courses were at least 4 years.
methodsThis two-center, retrospective study included patients with moderate-to-severe plaque psoriasis treated with secukinumab, guselkumab, or risankizumab. For reimbursement, patients were required to have Psoriasis Area and Severity Index (PASI) ≥ 10, whereas pivotal trials required PASI ≥ 12 and body surface area ≥ 10%. Patients were classified into short-term (≤ 2.5 years, reimbursed) and long-term (4-6 years, clinical trials) treatment groups. Disease relapse was assessed at each visit, and DFR was evaluated using Kaplan-Meier analysis and Cox regression.
resultsAmong 164 patients, 51 received long-term therapy and 113 received short-term therapy. Long-term therapy was associated with longer DFR (median 211 vs. 111 days, log-rank p < 0.001). In multivariate analysis, long-term risankizumab reduced relapse risk by 66% (hazard ratio [HR] 0.34, 95% confidence interval [CI] 0.13-0.90, p = 0.03), with a non-significant trend for long-term guselkumab (HR 0.55, 95% CI 0.28-1.06, p = 0.07). In contrast, no significant difference was observed for secukinumab (log-rank p = 0.94). In the guselkumab subgroup, continuous long-term therapy resulted in numerically higher remission days per dose than interrupted sequential short-term therapy (9.61 ± 11.43 vs. 8.23 ± 2.78, p = 0.64).
conclusionLong-term treatment with interleukin (IL)-23 inhibitors (particularly risankizumab), but not anti-IL-17 inhibitors, may prolong DFR, suggesting a potential disease-modifying effect of prolonged IL-23 inhibition. These findings should be considered preliminary and warrant confirmation in larger prospective studies.
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