title: Frequency and predictors of a high clinical response in patients with psoriasis on biological therapy in daily practice: results from the prospective, multicenter BioCAPTURE cohort.
abstract: BACKGROUND
  It is important to assess which patients with psoriasis are more likely to achieve high clinical responses on biologics.
  
  
  OBJECTIVE
  To assess the number of treatment episodes (TEs) that achieve a 100% improvement in Psoriasis Area and Severity Index (PASI 100), PASI 90 or PASI ≤ 5 at week 24 of biological treatment, and which baseline patient characteristics predict treatment response.
  
  
  METHODS
  Data from patients with psoriasis treated with adalimumab, etanercept, infliximab or ustekinumab were extracted from a prospective cohort. TEs with high clinical responses were described. Uni- and multivariate regression analyses were performed with the generalized estimating equation method to elucidate which baseline patient characteristics were predictors for PASI 90 and PASI ≤ 5 at week 24.
  
  
  RESULTS
  In total, 454 TEs were extracted (159 adalimumab; 193 etanercept; 19 infliximab; 83 ustekinumab) from 326 patients. At week 24, in 3%, 15% and 59% of TEs, respectively, PASI 100, PASI 90 and PASI ≤ 5 was reached. In TEs without a PASI 100 or PASI 90 response, PASI ≤ 5 was still achieved in 58% and 52%, respectively. Baseline PASI ≥ 10 was a strong predictor for achieving PASI 90; baseline PASI < 10 and a lower baseline body mass index (BMI) were significant predictors for PASI ≤ 5 at week 24.
  
  
  CONCLUSIONS
  A limited number of patients achieved PASI 100 or PASI 90 at 24 weeks of biological treatment. Including an absolute PASI score in the assessment of psoriasis severity is important. Baseline BMI was an important, modifiable predictor for a high response.
authors.affiliation: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Zweegers
authors.affiliation: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: B
authors.initials: B
authors.lastname: Roosenboom
authors.affiliation: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: P C M
authors.initials: PC
authors.lastname: van de Kerkhof
authors.affiliation: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: J M P A
authors.initials: JM
authors.lastname: van den Reek
authors.affiliation: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: M E
authors.initials: ME
authors.lastname: Otero
authors.affiliation: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Atalay
authors.affiliation: Maxima Medisch Centrum, Eindhoven/Veldhoven, the Netherlands.
authors.forename: A L A
authors.initials: AL
authors.lastname: Kuijpers
authors.affiliation: Gelre Ziekenhuizen, Apeldoorn, the Netherlands.
authors.forename: M I A
authors.initials: MI
authors.lastname: Koetsier
authors.affiliation: Ziekenhuis Gelderse Vallei, Ede, the Netherlands.
authors.forename: W P
authors.initials: WP
authors.lastname: Arnold
authors.affiliation: Slingeland Ziekenhuis, Doetinchem, the Netherlands.
authors.forename: M A
authors.initials: MA
authors.lastname: Berends
authors.affiliation: Jeroen Bosch Ziekenhuis, Den Bosch, the Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Weppner-Parren
authors.affiliation: Ziekenhuisgroep Twente, Almelo/Hengelo, the Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Bijen
authors.affiliation: Ziekenhuisgroep Twente, Almelo/Hengelo, the Netherlands.
authors.forename: M D
authors.initials: MD
authors.lastname: Njoo
authors.affiliation: St. Anna Ziekenhuis, Geldrop, the Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Mommers
authors.affiliation: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: P P M
authors.initials: PP
authors.lastname: van Lümig
authors.affiliation: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: R J B
authors.initials: RJ
authors.lastname: Driessen
authors.affiliation: Department of Epidemiology, Biostatistics and Health Technology Assessment, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: W
authors.initials: W
authors.lastname: Kievit
authors.affiliation: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.|Radboud University Nijmegen, Nijmegen, the Netherlands.
authors.forename: E M G J
authors.initials: EM
authors.lastname: de Jong
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use; D001685:Biological Factors / Q000627:therapeutic use*; D000068800:Etanercept / Q000627:therapeutic use; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D000069549:Ustekinumab / Q000627:therapeutic use
chemical_list: D001685:Biological Factors; D000069285:Infliximab; D000069549:Ustekinumab; D000068879:Adalimumab; D000068800:Etanercept