WEDNESDAY, June 19, 2024 -- Factors negatively associated with treatment outcomes in patients with psoriasis include previous exposure to biologics, higher body mass index (BMI), and current smoking, according to a meta-analysis published online June 18 in JAMA Dermatology.

Gustav Hjort, from Copenhagen University Hospital -- Herlev and Gentofte in Denmark, and colleagues conducted a systematic review to examine the association between patient clinical characteristics and effectiveness of biologics in treating psoriasis. Studies that reported treatment outcomes as a reduction in the Psoriasis Area and Severity Index (PASI) of 75 percent (PASI 75) or PASI 90 after 12, 26, and/or 52 weeks of treatment were reviewed; data were included from 40 studies, with 21,438 patients.

The researchers observed negative associations for older age, previous exposure to biologics, higher BMI, previous smoking, and current smoking with achieving PASI 90 at six months in observational studies (odds ratios [95 percent confidence intervals], 0.99 [0.98 to 1.00], 0.44 [0.29 to 0.67], 0.96 [0.94 to 0.99], 0.81 [0.67 to 0.98], and 0.78 [0.66 to 0.91], respectively). Only BMI of 30 kg/m2 or higher was negatively associated with treatment response in randomized clinical trials (PASI at three months; odds ratio, 0.57; 95 percent confidence interval, 0.48 to 0.66).

"There is a lack of evidence regarding whether these effects, as well as others, vary by biologic therapy," the authors write. "Future studies on this topic may guide clinicians to stratify treatment based on patient characteristics."

Several authors disclosed ties to the pharmaceutical industry.