Quick Win, Durable Victory or Both? Rethinking Psoriasis Biologics After PSoHO

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Quick Win, Durable Victory or Both? Rethinking Psoriasis Biologics After PSoHO

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Skin, joints, and staying power—because in psoriasis, “getting clear” is only half the story. In this episode of the Skin and Joints Podcast 🎧, dermatologist Dr. Chih-ho Hong and rheumatologist Dr. May Kazem team up again for a lively, multidisciplinary deep dive into new 24-month real-world data from PSoHO 📊, an international prospective observational study of biologic-treated patients with moderate-to-severe psoriasis. The big question? Not just who gets patients clear ✨—but what gets them clear quickly ⏱️ and keeps them there for the long haul 🏃‍♂️. This analysis looks at 24-month effectiveness and durability across biologic classes, then zooms in 🔍 on several individual biologics from IL-17 to IL-23 and TNF-I . But here’s the catch—and it’s a clinically juicy one: durability was defined very stringentIly. Patients had to achieve PASI90 or PASI100 by week 12 🎯 and then maintain that same response at months 6, 12, 18, and 24 📆. In other words, this is not a “looked good once and disappeared” kind of outcome 👻. This is the biologic equivalent of showing up early, staying consistent, and never ghosting the follow-up visit ✅. Dr. Hong and Dr. Kazem bring the classic Skin and Joints perspective: how should clinicians interpret biologic class comparisons? Within class comparisons? And why does durability sound simple until you realize it rewards treatments that are both fast starters ⚡ and long-distance runners 🏃‍♀️? Expect practical pearls 💎, careful interpretation 🧠, and a reminder that real-world evidence is incredibly useful 🔬—as long as we read the fine print before declaring a winner 🏆. Based on the attached podcast conversation emphasizing multidisciplinary care, real-world caveats, patient priorities, and the importance of viewing psoriasis as more than “just skin.” 🎯 Learning Objectives After listening to this episode, learners should be able to: Describe the PSoHO study design 📊, including its role as an international, prospective, observational study of biologic-treated patients with moderate-to-severe psoriasis. Explain 24-month effectiveness and durability ⏱️, including why maintaining PASI90 or PASI100 across multiple time points is a more demanding measure of sustained treatment success. Interpret stringent durability outcomes with caution 🧠, recognizing that this definition favors therapies that achieve early clearance and then maintain it over time. Compare biologic classes and individual agents 🔍, including how performance may be understood in the context of real-world treatment decisions. Apply a multidisciplinary skin-and-joints lens , considering skin clearance, psoriatic arthritis risk, patient-reported impact, comorbidities, and treatment persistence. Recognize the strengths and limitations of real-world observational data, including confounding by indication, patient selection, and why association does not automatically equal causation #SkinAndJoints #PsoriaticArthritis #Psoriasis #Dermatology #Rheumatology #Ixekizumab #PROSPIRIT #RealWorldEvidence #InflammatoryDisease #Biologics #bDMARDs #tsDMARDs #IL17 #MedEd #HCPeducation #DermRheum #PatientCentredCare #ClinicalPractice #Podcast #Vodcast Episode supported by an IME Grant from Eli Lilly. ABOUT Dr. Chih-ho Hong, MD, FRCPC Dermatologist, Vancouver, BC Dr. Hong is a board-certified dermatologist working in Greater Vancouver BC, Canada. He runs a busy office-based dermatology clinic with a focus on clinical research. He is a Clinical Associate Professor in the Department of Dermatology and Skin Sciences and teaches at St. Paul’s Hospital in Vancouver, where he is active staff. Dr. Hong is the past head of the BC Section of Dermatology, the current Economics representative for Dermatology at the BCMA, and is the past chair of the Education Committee of the Canadian Dermatology Association. He is also a past examiner in Dermatology for the Royal College of Physicians of Canada residency qualification examination. He is currently the Canadian representative to SPIN (The Skin Inflammation and Psoriasis International Network) – spindermatology.org Dr. Hong is active in clinical practice and dermatology research. His main clinical areas of interest are psoriasis and eczema. He has been an investigator in over 150 trials of treatments in dermatology and has over 50 peer reviewed publications. He has lectured locally, nationally, and internationally on dermatology treatments and has been an invited speaker at international dermatology congresses. ABOUT Dr. May Kazem, MD, FRCPC Rheumatologist, Vancouver, BC Dr. Mikameh “May” Kazem is a Canadian rheumatologist based in Vancouver, BC. She holds an undergraduate degree in biotechnology and a Master’s in Health Administration. She completed her Internal Medicine residency at the University of British Columbia, followed by Rheumatology fellowship ...

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