title: Development of clinical prediction models for good or bad response to classic systemic drugs, anti-TNFs, and ustekinumab in psoriasis, based on the BIOBADADERM cohort.
abstract: BACKGROUND
  Identifying patients likely to have very good or bad results from systemic psoriasis therapy could improve efficiency of therapy.
  
  
  OBJECTIVE
  To develop prognostic models for good or bad response to classic systemic drugs, anti-TNFs, and ustekinumab in psoriasis.
  
  
  METHODS
  Multivariable logistic regression of a prospective multicenter cohort of psoriatic patients in clinical practice (6449 person-years of follow-up). We used as possible predictors demographic characteristics, comorbidities, characteristics of the psoriasis (type, PASI, arthritis), history of past therapy at entry in the cohort, and history of response to previous cycles while in the cohort. We defined good response to a treatment cycle as either cycle end due to disease remission or a cycle longer than 2 years that does not end later due to inefficacy in the follow-up period. Bad response to a treatment cycle was defined as a cycle that is finished due to inefficacy, based on the physician judgment, after more than 3 months of treatment.
  
  
  RESULTS
  Patients with fewer previous therapies, lower body mass index, older at start of therapy, and with previous history of good responses to therapy are more likely to have positive results of therapy. However, the predictive characteristics of models are poor.
  
  
  CONCLUSIONS
  Predictive models of clinical response to systemic drugs in psoriasis with the studied variables do not seem to outperform drug selection by a dermatologist.
authors.affiliation: a Research Unit , Fundación Academia Española de Dermatología y Venereología , Madrid , Spain .|b Department of Dermatology , Complexo Hospitalario Universitario de Vigo , Vigo , Spain .
authors.forename: Ignacio
authors.initials: I
authors.lastname: García-Doval
authors.affiliation: a Research Unit , Fundación Academia Española de Dermatología y Venereología , Madrid , Spain .|c Research Unit , Complejo Hospitalario Universitario de Albacete , Albacete , Spain .
authors.forename: Beatriz
authors.initials: B
authors.lastname: Pérez-Zafrilla
authors.affiliation: d Department of Dermatology , Hospital Universitario Germans Trias i Pujol, Badalona, Universitat Autónoma de Barcelona , Spain .
authors.forename: Carlos
authors.initials: C
authors.lastname: Ferrandiz
authors.affiliation: e Department of Dermatology , Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria , Spain .
authors.forename: Gregorio
authors.initials: G
authors.lastname: Carretero
authors.affiliation: f Department of Dermatology , Hospital Universitario La Princesa , Madrid , Spain .
authors.forename: Esteban
authors.initials: E
authors.lastname: Daudén
authors.affiliation: g Department of Dermatology , Hospital Infanta Leonor , Madrid , Spain .
authors.forename: Pablo
authors.initials: P
authors.lastname: de la Cueva
authors.affiliation: h Department of Dermatology , Hospital Universitario Reina Sofía , Córdoba , Spain .
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Gómez-García
authors.affiliation: i Department of Dermatology , Hospital Universitario Virgen de la Victoria , Málaga , Spain .
authors.forename: Enrique
authors.initials: E
authors.lastname: Herrera-Ceballos
authors.affiliation: j Department of Dermatology , Hospital General Universitario de Alicante , Alicante , Spain .
authors.forename: Isabel
authors.initials: I
authors.lastname: Belinchón-Romero
authors.affiliation: k Department of Dermatology , Hospital General Universitario de Valencia , Valencia , Spain .
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Sánchez-Carazo
authors.affiliation: l Department of Dermatology , Hospital Universitario Fundación Alcorcón , Madrid , Spain .
authors.forename: Jose-Luis
authors.initials: JL
authors.lastname: López-Estebaranz
authors.affiliation: m Department of Dermatology , Hospital Universitario Clinic de Barcelona , Barcelona , Spain .
authors.forename: Merce
authors.initials: M
authors.lastname: Alsina
authors.affiliation: n Department of Dermatology , Hospital del Mar, Parc de Salut Mar , Barcelona , Spain , and.
authors.forename: Marta
authors.initials: M
authors.lastname: Ferrán
authors.affiliation: e Department of Dermatology , Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria , Spain .
authors.forename: Rosa
authors.initials: R
authors.lastname: Torrado
authors.affiliation: d Department of Dermatology , Hospital Universitario Germans Trias i Pujol, Badalona, Universitat Autónoma de Barcelona , Spain .
authors.forename: Jose-Manuel
authors.initials: JM
authors.lastname: Carrascosa
authors.affiliation: o Department of Dermatology , Hospital Universitario 12 de Octubre , Madrid , Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Rivera
authors.affiliation: o Department of Dermatology , Hospital Universitario 12 de Octubre , Madrid , Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Vanaclocha
mesh_terms: D000328:Adult; D000368:Aged; D001691:Biological Therapy; D015992:Body Mass Index; D003879:Dermatologic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011379:Prognosis; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D000069549:Ustekinumab / Q000627:therapeutic use*
chemical_list: D003879:Dermatologic Agents; D007166:Immunosuppressive Agents; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha; D000069549:Ustekinumab
keywords: Anti-inflammatory agents; biological agents; immunosupresive agents; prognosis; psoriasis/drug therapy; treatment outcome