P83 Baseline characteristics of the BeNeBio cohort: dose reduction of the new generation biologics (IL-17 and IL-23 inhibitors) in psoriasis: a pragmatic, multicentre, randomized, controlled, non-inferiority study

Abstract Biologics for psoriasis are highly effective but expensive. Dose reduction (DR) of the first-generation biologics has proven to be safe and (cost-)effective. However, data on DR of the newest biologics is scarce. This pragmatic non-inferiority study evaluates whether controlled DR of IL-17 and IL-23 inhibitors in psoriasis patients with low disease activity is non-inferior to usual care (UC). A total of 244 patients, receiving UC of IL-17/IL-23 inhibitors with psoriasis area and severity index (PASI) ≤5 for at least 6 months, and PASI and Dermatology Life Quality Index (DLQI) ≤5 at inclusion, were randomized 2:1 to DR (interval prolongation to 66 and 50% of UC) or UC. Outcomes: difference in cumulative incidence of persistent flares (PASI >5 for ≥3 months: primary) and proportion of patients with successful DR, course of PASI and DLQI, safety, costs, and pharmacokinetic profile (secondary). Two hundred and forty-four patients (100%) were included: 14% used secukinumab, 25% ixekizumab, 6% brodalumab, 1% bimekizumab, 30% guselkumab, 21% risankizumab and 3% tildrakizumab. The mean age was 51 years, mean body mass index (BMI) 27.5, 67% was male, 14% had concomitant psoriatic arthritis, median disease duration was 21 years [interquartile range (IQR) 20], 47% was biologic naive, and median psoriasis area and severity index (PASI) and DLQI were 0.0 (IQR 1.1 and 1.0, respectively). The baseline characteristics highlight a very low PASI and DLQI (both median 0) at inclusion while the threshold was PASI and DLQI ≤5, a relatively low mean BMI compared with general biologic cohorts, and a well-balanced proportion of biologic naivety vs. non-naivety.