Drug Survival of Systemic Therapies for Psoriasis in the Western Japan Psoriasis Registry: 2024 Update

Drug survival is a useful composite measure reflecting treatment effectiveness, safety, convenience, and patient satisfaction in routine clinical practice. The Western Japan Psoriasis Registry (WJPR) is a prospective multicenter observational registry involving 34 dermatology centers in western Japan that continuously collects real-world data on systemic therapies for patients with psoriasis. Yanase et al. previously reported drug survival in 1674 treatment episodes initiated between 2010 and 2020 within the WJPR; however, large-scale real-world data including recently introduced agents remain limited. We analyzed the drug survival of systemic therapies using data from 2251 patients and 4002 treatment episodes recorded in the WJPR between 2018 and 2024. Drug survival was assessed using the Kaplan-Meier method, and analyses were performed overall and stratified according to body mass index (BMI), psoriatic arthritis (PsA), previous biologic exposure, and sex. Multivariable Cox proportional hazards analyses were also performed for drugs with approved indications for PsA. Drug survival differed among treatments, with risankizumab demonstrating the most favorable persistence throughout the observation period, while guselkumab and ixekizumab also showed favorable drug survival. No significant differences in drug survival were observed according to BMI category. However, drug survival tended to be lower overall in patients with PsA, biologic-experienced patients, and women. Among patients with PsA, bimekizumab maintained relatively favorable drug survival despite the generally lower treatment persistence observed in this subgroup. Multivariable analyses identified previous biologic exposure as the most consistent predictor of treatment discontinuation, whereas BMI was not independently associated with drug survival in any analyzed drug.