P01 The efficacy of biological agents in the management of psoriasis in South Korea: a single centre study

Abstract Biological agents (BAs) are increasingly becoming the primary treatment for psoriasis, with several BAs currently in use. Each agent operates with slight variations in mechanism and efficacy. The BAs utilized in our clinic include risankizumab (RM), secukinumab (SM), guselkumab (GM) and ustekinumab (UM). This study presents our findings from 12 weeks to 18 months of biologic treatment administered to psoriasis patients. The objective of this study was to determine which BA exhibits effectiveness and stability over an extended period, particularly in treating plaque psoriasis. From January 2018 to October 2023, we investigated a total of 163 cases of patients (RM 43 cases, SM 50 cases, GM 42 cases and UM 28 cases) who were treated with BAs over 18 months. Psoriasis area and severity index (PASI) scores were assessed at five intervals: initially, at 12–16 weeks post-initial BA administration, and then at 6/12/18 months. We analysed the PASI 100 rate (complete remission rate), the rate of switching to another BA, and the PASI 75/90/100 response rates according to the specific biologic agent. Our findings indicate that the PASI 75 ratio, commonly considered a treatment goal in psoriasis management, was largely achieved in patients treated with RM, SM, and GM, suggesting similar treatment effectiveness among these agents. However, the PASI 100 rate was notably higher in RM and GM compared with the other two BAs. UM exhibited the lowest PASI 100 rate and the highest rate of switching. Incorporating data from previous studies alongside our own, it is suggested that selectively blocking interleukin-23 (IL-23) via the inhibition of the p19 subunit rather than p40 leads to a more comprehensive inhibition of IL-23 activity.