P115 Long-term outcomes of biologic-naive and biologic-experienced patients, with a focus on women of childbearing age with chronic plaque psoriasis treated with certolizumab pegol

Abstract Certolizumab pegol (CZP) is an Fc-free, PEGylated tumour necrosis factor inhibitor (TNFi) approved for the treatment of plaque psoriasis and psoriatic arthritis. CZP has no to minimal placental transfer during pregnancy and is recommended as a first-line biologic in women planning conception. This analysis aims to investigate the baseline characteristics and real-world effectiveness of patients with CZP enrolled in the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR), with a focus on women of childbearing age. The BADBIR CZP cohort included patients aged ≥ 18 years initiated on CZP for chronic plaque psoriasis. Patients were stratified according to biologic experience status (naive or experienced) and women of childbearing age (defined as female patients aged 18–45 years). The analytical outcomes were patient characteristics (biologic status, age, sex), Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) scores reported at baseline (when a patient registered with BADBIR). The 12-month drug survival and PASI and DLQI scores were reported at 12 months post-CZP. Overall, 313 patients with chronic plaque psoriasis treated with CZP were identified (data lock: 1 August 2023). Eighty-three (26.5%) patients were biologic naive and 230 (73.5%) were biologic experienced; 228 (72.9%) patients were within the range for women of childbearing age. At baseline, the mean (SD) PASI and DLQI scores were higher in the biologic-naive subgroup than in the biologic-experienced subgroup [PASI: 15.3 (7.4) vs. 8.5 (8.3), P < 0.001; DLQI: 17.5 (6.9) vs. 9.9 (7.9), P = 0.002]. In women of childbearing age, mean (SD) baseline PASI and DLQI scores were 10.7 (8.1) and 14.0 (8.5), respectively. At 12 months, 80% of biologic-naive patients [95% confidence interval (CI) 68–88], 74% (95% CI 68–80) of biologic-experienced patients and 75% (95% CI 68–81) of women of childbearing age were still on treatment. Among patients with available data, 14 of 22 (64%) in the biologic-naive subgroup and 31 of 57 (54%) in the biologic-experienced subgroup achieved a PASI score ≤ 2 at 12 months after exposure; 32 of 55 (58%) women of childbearing age achieved a PASI score ≤ 2 at 12 months after exposure. Nearly half of the patients with available data in both biologic subgroups achieved a DLQI of 0 or 1 at 12 months (biologic naive: 6 of 13, 46% vs. biologic experienced: 8 of 17, 47%). Within the women of childbearing age range, 12 of 22 (55%) patients achieved a DLQI of 0 or 1 at 12 months. The real-world use of CZP for chronic plaque psoriasis in a UK population from BADBIR has shown that most patients initiated on CZP were women of childbearing age, a patient population where family planning may be a consideration. CZP was also reported to have good effectiveness on skin and patient-reported quality-of-life scores. Drug survival was high at 12 months across all subgroups, consistently with other TNFis.