Clinical Report: Psoriasis Biologics Face Off in Drug Survival Study

Overview

A recent cohort study indicates that ustekinumab has superior drug survival compared to adalimumab and secukinumab among bionaive patients. In bioexperienced patients, bimekizumab, guselkumab, and risankizumab demonstrated the highest 2-year drug survival rates.

Background

Psoriasis is a chronic inflammatory skin condition that significantly impacts patients' quality of life. The choice of biologic therapy can affect treatment persistence and overall patient outcomes. Understanding drug survival rates among different biologics is crucial for optimizing treatment strategies in clinical practice.

Data Highlights

Key Findings

• Ustekinumab showed the lowest 5-year treatment discontinuation risk at 37% among bionaive patients.
• Among bioexperienced patients, bimekizumab, guselkumab, and risankizumab had the highest 2-year drug survival rates.
• Adalimumab and secukinumab had higher discontinuation rates at 51% and 54%, respectively, compared to ustekinumab.
• 1-year drug survival was lower for several agents in bioexperienced patients compared to bionaive patients.
• Overall, treatment persistence varies significantly across different biologics, influencing therapy selection.

Clinical Implications

The findings suggest that ustekinumab may be a preferable first-line biologic for bionaive patients due to its higher drug survival. For bioexperienced patients, bimekizumab, guselkumab, and risankizumab may be more effective options, highlighting the importance of individualized treatment plans.

Conclusion

This study underscores the importance of understanding drug survival rates among biologics for psoriasis, which can guide clinicians in making informed treatment decisions.

References

1. Schwarz, C.W., et al., JAMA Dermatology, 2025 -- Drug Survival of Biologics in Bionaive and Bioexperienced Patients With Psoriasis
2. Conexiant, 2023 -- Biologics Tied to Lower Eye Risk in Psoriasis
3. Drugs - Real World Outcomes, 2023 -- Impact of Biologic and Non-Biologic Therapies on Dermatology Life Quality Index Scores in Psoriasis Patients in Malaysia
4. Drugs - Real World Outcomes, 2024 -- Evaluation of Ixekizumab's Effectiveness in Psoriasis Patients Transitioning from IL-23 Inhibitors and Other Biologics
5. Living EuroGuiDerm Guideline for the systemic treatment of psoriasis vulgaris | EDFG, 2025
6. Guselkumab versus secukinumab for the treatment of moderate-to-severe psoriasis (ECLIPSE), ScienceDirect
7. Drug Safety — Evaluating the Long-Term Safety Profile of Guselkumab in Psoriatic Disease: A Comprehensive Review of Eleven Phase II/III Trials Involving Psoriasis and Psoriatic Arthritis
8. Living EuroGuiDerm Guideline for the systemic treatment of psoriasis vulgaris | EDFG
9. Guselkumab versus secukinumab for the treatment of moderate-to-severe psoriasis (ECLIPSE): results from a phase 3, randomised controlled trial - ScienceDirect
10. Drug Survival of Biologics in Bionaive and Bioexperienced Patients With Psoriasis - PubMed