Worsened quality of life and increased comorbidity risk associated with multibiologic failure in patients with psoriasis

Summary: Abstract Body: Psoriasis is a chronic condition that has a significant physical and mental health burden. Biologic agents that target dysregulated immune pathways have revolutionized the treatment of plaque psoriasis. While many individuals experience effective disease management with single biologic use, some patients experience psoriasis that is refractory to treatment. Cycles of biologics can lead to frustration, poor mental health, and an increased financial burden. Previous research has identified factors like disease severity, genetics, age, and smoking as risk factors associated with biologic failure. This study aims to investigate the differences between 258 individuals who experience multibiologic failure (MBF), defined as the previous or current use of 3 or more biologics, compared to 504 individuals who have only used a single biologic (SB) amongst the All of Us Research Program. Univariate analysis revealed that the MBF and SB cohorts were similar in demographics. Multivariate logistic regression controlling for age, sex, race, and total systemic medications tried revealed that MBF was significantly associated with worse quality of life measures, including increased odds of mild fatigue (ORa = 2.03; 95% CI: 1.13, 3.78) and decreased odds of having very good social satisfaction (ORa = 0.60; 95% CI: 0.37, 0.99) and general mental health (ORa = 0.53, 95% CI: 0.33, 0.85). MBF was also significantly associated with increased odds of comorbidities like obstructive sleep apnea (ORa = 1.47; 95% CI: 1.05, 2.05) and psoriatic arthritis (ORa = 1.76; 95% CI: 1.27, 2.46). These findings underscore the importance of identifying and addressing the significant impact on quality of life and additional health risks of patients who experience MBF. Andrea Leung¹, Alina Feng¹, Georgia Marquez-Grap¹, Allison Kranyak¹, Guy Eakin², Di Yan³, Jessica Kaffenberger⁴, Wilson Liao¹ 1. Dermatology, University of California San Francisco, San Francisco, CA, United States. 2. National Psoriasis Foundation, Alexandria, VA, United States. 3. Dermatology, University of Wisconsin-Madison, Madison, WI, United States. 4. Dermatology, The Ohio State University, Columbus, OH, United States. Clinical Research: Epidemiology and Observational Research