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Racial/ethnic differences in treatment efficacy and safety for moderate-to-severe plaque psoriasis: a systematic review

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Abstract

Biologic medications have revolutionized treatment of psoriasis; however, there remains uncertainty in which medications should be used to maximize efficacy based on race/ethnicity. The purpose was to determine if efficacy of biological medications differs based on race/ethnicity. A systematic review identified all clinical trials focused on biologic treatment outcomes from inception of database until March 5th, 2021. Included studies provided data on racial/ethnic differences in biologic skin clearance efficacy using the Psoriasis Area and Severity Index (PASI) and “clear/almost clear” scores. There were 1220 studies identified, and 24 included in the review. The races/ethnicities included were Asian (n = 2740), White (n = 9745), Black (n = 138), and Latino (n = 728). Ixekizumab provided the highest “clear/almost clear” score (90.7%, 89.4%) and PASI 75 (98.8%, 96.6%) for Asian and Latino patients, respectively. Guselkumab had the highest “clear/almost clear” score for White (86.8%) patients, while Black patients had highest “clear/almost clear” (75.0%) and PASI 75 (91.7%) scores to brodalumab. Limitations included lack of studies reporting outcome data based on race/ethnicity and lack of patients of color within psoriasis clinical trials. For treatment of plaque psoriasis, there is evidence of differences in efficacy of biologics improving clinical disease severity between different races or ethnicities.

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Acknowledgements

We would like to thank Dr Steven R Feldman MD for helping finalize the manuscript.

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Authors and Affiliations

  1. Division of Dermatology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA

    Jessica E. Ferguson & Edward W. Seger

  2. School of Medicine, University of Kansas, Kansas City, KS, USA

    Jessica E. Ferguson & Jacob White

  3. Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Amy McMichael

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  1. Jessica E. Ferguson
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  2. Edward W. Seger
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  4. Amy McMichael
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Contributions

Conceptualization: JEF. Literature Search: JW, MLS. Data Analysis: JEF and EWS, MD. Writing—original draft preparation: JEF. Writing—review and editing: EWS, MD & AM, MD.

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Correspondence to Jessica E. Ferguson.

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Ferguson, J.E., Seger, E.W., White, J. et al. Racial/ethnic differences in treatment efficacy and safety for moderate-to-severe plaque psoriasis: a systematic review. Arch Dermatol Res 315, 41–50 (2023). https://doi.org/10.1007/s00403-022-02324-4

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