Introduction: Biologic therapy has
revolutionalised the treatment of moderate to severe
psoriasis leading to improved clinical outcomes and
quality of life scores. This study aims to determine
current biologic use in psoriatic patients at our
Dermatology department at Sir Paul Boffa hospital,
Malta.
Method: All patients who were administered
biologic therapy for psoriasis in Malta until the end
of 2014 were included. Data included demographic
details, disease duration and severity, biologic use
and duration, previously attempted treatments, side
effects, early and late response to biologic using
Psoriasis Area Severity Index (PASI) scores and
Dermatology Life Quality index (DLQI) scores.
Results: A total of 36 patients were started on a
biologic between 2009 and 2014 for psoriasis
(M:25, F:11) with a mean age of 46.9 years. These
included etanercept (n=22), infliximab (n=8),
adalimumab (n=4) and ustekinumab (n=2).
Secondary failure was the main reason why
biologics were stopped and switched. Most patients
had an improvement in their PASI scores after 2 to
4 weeks of starting the biologic and had a PASI 90
score improvement. All patients had more than a 5
point improvement in DLQI score.
Discussion: Biologic use in our department is
on the increase. Our patients had considerable
improvements in their PASI and DLQI scores.
Secondary failures have occurred usually after 2 to
4 years and switching has yielded positive results.
Biologics are expensive drugs and recently we have
switched to cheaper biosimilars. Doctors should be
aware of the treatment options available for
psoriasis patients, their possible side effects and
when to refer to our department. In most cases a
satisfactory response can be achieved.peer-reviewe
