title: Review of maintenance of response to psoriasis treatments.
abstract: BACKGROUND
  Biologics are highly effective treatments for moderate-severe psoriasis with a high percentage of patients achieving 75% improvement in Psoriasis Area Severity Index (PASI75) at 12 weeks. However, psoriasis is a chronic disease, and long-term efficacy is critical.
  
  
  OBJECTIVE
  Long-term responses of systemic psoriasis treatments and how this effect is reported.
  
  
  METHODS
  A PubMed literature was performed to identify studies describing long-term response rates to available systemic psoriasis treatments. Within these studies, we examined how maintenance rates were reported. All studies with long-term efficacy data ranging from 24 to 244 weeks were considered.
  
  
  RESULTS
  Thirteen studies met the inclusion criteria. When comparing medications at 1 year, response rates among the initial treatment groups were best with secukinumab (65.2%) and worst with apremilast (18.7%). Among only initial responders at 10-16 weeks who received 1 year of continuous treatment, maintenance was best with adalimumab (95.2%) and worst with apremilast (61%).
  
  
  CONCLUSIONS
  The different methodologies used to report maintenance of response over time make it difficult to compare response rates across drugs studied in different trials.
  
  
  CONCLUSIONS
  Long-term response rates of systemic treatment of psoriasis are high. Effect may be influenced by many factors and can be analyzed in different ways, making comparisons across different trials difficult.
authors.affiliation: a Center for Dermatology Research, Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA .
authors.forename: Simona
authors.initials: S
authors.lastname: Bartos
authors.affiliation: a Center for Dermatology Research, Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA .
authors.forename: Dane
authors.initials: D
authors.lastname: Hill
authors.affiliation: a Center for Dermatology Research, Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA .|b Department of Pathology , Wake Forest School of Medicine , Winston-Salem , NC , USA and.|c Department of Public Health Sciences , Wake Forest School of Medicine , Winston-Salem , NC , USA.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
mesh_terms: D000328:Adult; D001688:Biological Products / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D001688:Biological Products
keywords: Treatment efficacy; health care delivery; long-term; phase 3 trials; statistics