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ORIGINAL RESEARCH article

Front. Med.
Sec. Dermatology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1488096

Development and external validation of a prediction model for the risk of relapse in psoriasis after discontinuation of biologics

Provisionally accepted
Shan Huang Shan Huang 1Bailin Chen Bailin Chen 2*Yiming Qi Yiming Qi 2*Xingwu Duan Xingwu Duan 1*Ping Yan Bai Ping Yan Bai 3*
  • 1 Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
  • 2 Beijing University of Chinese Medicine, Beijing, China
  • 3 Department of Dermatology, China-Japan Friendship Hospital, Beijing, Beijing Municipality, China

The final, formatted version of the article will be published soon.

    Background: Some patients with psoriasis experience relapses shortly after discontinuation of biologics. However, there is a lack of risk prediction tools to identify those at high risk of relapse.Objective: To develop and validate a risk prediction model for psoriasis relapse after biologics discontinuation.Methods: Publications from PubMed, EMBASE, Medline, and the Cochrane Library were systematically searched and meta-analyses were conducted to identify risk factors for psoriasis relapse after biologics discontinuation. Statistically significant risk factors were identified and used to create a risk assessment model weighted by the impact of each factor. The model was externally validated using a cohort of 416 Chinese psoriasis patients.Results: Eight studies (N=2066) were included in the meta-analysis. Body mass index (BMI), smoking, disease duration, comorbid psoriatic arthritis (PsA), remission speed and extent during treatment, history of biologic therapy, and therapy duration were identified as correlates of relapse in the meta-analysis and were incorporated into the prediction model. The median age of the 416 patients in the validation cohort was 41.5 (IQR 32, 53) years, with 63% male, and a baseline PASI score of 15.4 (IQR 10.5,21). It was verified that the area under the curve (AUC) of the prediction model was 0.796 (95% CI: 0.753-0.839), with an optimal cut-off value of 11.25 points, sensitivity of 65.1%, and specificity of 82.2%. Conclusion: Multivariate models using available clinical parameters can predict relapse risk in psoriasis patients after biologics discontinuation. Early individual identification of patients at risk of relapse, and screening of candidate cohorts for long-term treatment or dose reduction may benefit both patients and physicians.

    Keywords: Psoriasis, biologics, relapse prediction model, risk factor, relapse

    Received: 06 Sep 2024; Accepted: 13 Nov 2024.

    Copyright: © 2024 Huang, Chen, Qi, Duan and Bai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Bailin Chen, Beijing University of Chinese Medicine, Beijing, China
    Yiming Qi, Beijing University of Chinese Medicine, Beijing, China
    Xingwu Duan, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
    Ping Yan Bai, Department of Dermatology, China-Japan Friendship Hospital, Beijing, 100029, Beijing Municipality, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.