Treatment Resistance to TNF-α Inhibitors in Patients with Psoriasis

Abstract

Background. Treatment resistance to biologic treatment at specific sites in the body is a challenging issue. However, there is insufficient evidence for factors affecting the resistance of these areas to biological therapies. Methods. In this study, patients with moderate-to-severetreatment-resistant psoriasis who were biologic naïve and referred to Razi hospital were included. The relationship between treatment resistance in different areas and demographic and clinical variables was investigated. Results. A total of 131 biologic-naïve patients with psoriasis treated with anti-TNF-α were included in this study. The most common resistant sites included the scalp, anterior lower legs, and elbows. Also, hand- and toe-nail involvements were considerable. BMI, gender, smoking, PASI score, the duration of the disease, the time distance between diagnosis and treatment, and treatment regiments were found to affect the incidence of resistance to treatment in multiple areas, while age, the incidence of recalcitrant disease and/or psoriatic arthritis, and the duration of current treatment did not have effects. Conclusion. The most common refractory sites were the scalp, anterior lower legs, and elbows. This study should be followed up with larger samples containing a variety of biological treatments in order to evaluate the results.