title: Switching from a biological therapy to another biologic agent in psoriatic patients: the experience of PsOMarche group.
abstract: BACKGROUND
  Switching is a "hot" topic and the main reasons for switching prior biologic agent are for a primary failure, a secondary failure or drug intolerance, patient's dissatisfaction, physician decision. The aim of the study was to assess the optimization of the switching from a biologic agent to another.
  
  
  METHODS
  Five Dermatological Units have participated to PsOMarche working group have studied thirty-eight patients affected moderate to severe chronic plaque psoriasis at time 0 (patient recruitment at time of switching from biological therapy to another), 8 weeks (T8), 16 weeks (T16).
  
  
  RESULTS
  Twenty-eight males and 10 females were included in the study. At T0, 18 of 22 patients treated with etanercept had been switched to adalimumab and 4 to ustekinumab. Among 10 patients treated with adalimumab, 5 had been switched to ustekinumab, 2 to golimumab and 3 to certolizumab pegol. One patient treated with Infliximab and 5 patients treated with ustekinumab had been switched to adalimumab. Switching had been performed for primary inefficacy in 9 patients (23.6%) and a secondary failure was evidenced in 29 patients (73.4%). PASI75 was achieved in 53% and in 89.4% of patients after 8 weeks and 16 weeks of switching to the second biologic agent respectively; similarly, PsoDISK score significantly decreased at T8 and T16.
  
  
  CONCLUSIONS
  The experience of PsOMarche group have shown that the switching to a biologic agent to another is a valuable treatment choice in patients with moderate to severe psoriasis experiencing a treatment failure with one biologic therapy, leading to a good improvement in skin disease and in patient's quality of life.
authors.affiliation: Dermatological Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Ganzetti
authors.affiliation: Dermatological Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy - anna.campanati@gmail.com.
authors.forename: Anna
authors.initials: A
authors.lastname: Campanati
authors.affiliation: UOC Dermatologia, Hospital of Macerata, ASUR Marche AV3, Macerata, Italy.
authors.forename: Alberta
authors.initials: A
authors.lastname: Bettacchi
authors.affiliation: Dermatological Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Brandozzi
authors.affiliation: Dermatological Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: Brisigotti
authors.affiliation: UOC Dermatologia, Carlo Urbani Hospital, ASUR Marche AV2, Jesi, Ancona, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Bugatti
authors.affiliation: Dermatological Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.
authors.forename: Ivana
authors.initials: I
authors.lastname: Cataldi
authors.affiliation: UOC Dermatologia, Carlo Urbani Hospital, ASUR Marche AV2, Jesi, Ancona, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Filosa
authors.affiliation: UOC Dermatologia INRCA/IRCCS, Ancona, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Giacchetti
authors.affiliation: Dermatological Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lemme
authors.affiliation: Unit of Dermatology INRCA/IRCCS, Fermo, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Morresi
authors.affiliation: UOC Dermatologia, Carlo Urbani Hospital, ASUR Marche AV2, Jesi, Ancona, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Nicolini
authors.affiliation: Dermatological Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Postacchini
authors.affiliation: UOC Dermatologia INRCA/IRCCS, Ancona, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ricotti
authors.affiliation: Dermatological Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Rosa
authors.affiliation: UOC Dermatologia, Hospital of Macerata, ASUR Marche AV3, Macerata, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Simonacci
authors.affiliation: Dermatological Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Offidani
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage; D001685:Biological Factors / Q000008:administration & dosage*; D001691:Biological Therapy / Q000379:methods; D003879:Dermatologic Agents / Q000008:administration & dosage*; D057915:Drug Substitution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy* / Q000503:physiopathology; D011788:Quality of Life; D012720:Severity of Illness Index; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D001685:Biological Factors; D003879:Dermatologic Agents