Investigation of the factors that cause drug discontinuation or change in psoriasis patients managed with biological drugs

Aim: In this study, it was aimed to reveal in detail the factors that lead to the discontinuation or change of the drug in psoriasis patients under biologic therapy. In previous studies on the subject, it has been shown that the duration of drug use is lower in female patients receiving biologic therapy, but there are not enough studies on the causes of this situation. While our study mainly aims to investigate the reasons for this situation with a detailed inquiry including the reasons that may be specific to women, it also plans to reveal the treatment satisfaction of the patients with a short and practical questioniare. Materials and Method: This cross-sectional study was carried out with patients over 18 years of age who applied to Karadeniz Technical University Faculty of Medicine, Dermatology general and psoriasis outpatient clinics, were diagnosed with psoriasis clinically or histopathologically, and were being treated with biologic drugs. A case report form was filled when the patients applied to the outpatient clinics for follow-up or when the researchers called the patient via the phone numbers in their file records, and the dermatological quality of life index (DYKI) questionnaire and a six-question satisfaction questionnaire created specifically for the study were applied to the patients. Findings: In this study, data of a total of 396 biological therapy series of 156 patients, 70 (44.8%) female and 86 (55.2%) male, were presented. 202 treatment series of male patients and 194 treatment series of female patients were compared. Depression, anxiety disorder, sleep disturbance, pain and itching symptoms and the presence of psoriatic arthritis were observed more frequently in female patients compared to male patients. When we examined the reasons for discontinuation of treatment, the reasons for discontinuation due to "ineffectiveness" were found to be significantly higher in women (p=0.025).There was no significant difference in terms of gender in the other treatment termination reason groups. According to their answers to the satisfaction questionnaire, female patients were found to be more "worried about side effects" than males (p=0.020). No gender difference was found for the other satisfaction survey questions. Results: It was observed that the number of biological therapy series was significantly higher in female patients. Female patients most frequently terminated their treatment because of ineffectiveness. The number of drug reactions and the number of treatments terminated for the purpose of having a child was more common in women than in men and they have almost exclusively been reasons for women. Female psoriasis patients ended their treatment because of lesions in the visible areas and because they could not respond to the pain symptom they suffered more than male patients. Low satisfaction with treatment increased the number of treatment series, but the available data did not provide a gender-specific explanation. Keywords: psoriasis, female, biological, drug survival, satisfaction