Efficacy, Safety, and Drug Survival During the First Year of Biologic Therapy for Psoriasis in Elderly Versus Younger Patients

ABSTRACT Background Older people represent an increasing proportion of patients treated with biologics for psoriasis. However, data availability is limited due to the underrepresentation of older patients in clinical trials. Materials and Methods This is a multicentric real‐world observational study conducted in dermatology centers in the Czech Republic. It aims to compare the efficacy, safety, and drug survival of biologics in psoriasis patients aged ≥ 65 years with matched controls aged 18–64 years (1:2 ratio) during the first year of treatment. Data were extracted from the prospective BIOREP registry and patient medical records for adverse events (AEs). Results A total of 265 elderly patients and 530 matched controls were included. In both groups, a similar proportion of patients achieved a Psoriasis Area and Severity Index (PASI) ≤ 2 after 14 weeks (67% older vs. 63% younger adults), 26 weeks (71% vs. 76%), and 52 weeks (72% vs. 76%). During the first year of biologic therapy, at least one AE was reported in 108 (41%) older and 214 (40%) younger patients. Serious adverse events (SAEs) were reported in 13 (5%) older and 16 (3%) younger patients. Drug survival during the first year of therapy was lower in older (88%) compared to younger patients (96%), especially in those treated with adalimumab (81% vs. 99%). Conclusion The efficacy of biological treatment was comparable between older and younger patients. Despite older people having more comorbidities, SAEs did not increase in this age group. Nonetheless, the survival rate of older patients was notably lower during the treatment period, especially when adalimumab was administered.