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    Can you maintain response after biologic holiday?

    Melinda Gooderham, M.D., MSc, FRCPCPatients might stop taking their biologic medications for a variety of reasons. When patients do stop their biologic therapy, clinicians need to consider that some biologic therapies are better at recapturing response than others.

    READ: Biologic use beyond psoriasis

    Speaking at the recent Dermatology Update in Ontario, Canada, Melinda Gooderham, M.D., MSc, FRCPC, explained that patients with psoriasis or psoriatic arthritis may need to interrupt their biologic therapy for a variety of reasons including expense, pregnancy, surgery, travel, the need for live vaccinations, and the presence of infections. Dr. Gooderham is the medical director of the Skin Centre for Dermatology in Peterborough, Ontario.

    "We know that patients take drug holidays, whether it's on their own or whether we decide this with them," says Dr. Gooderham. "What happens when they re-start the biologic?"

    Payment can be a barrier to continuous use of a biologic therapy, adds Dr. Gooderham. "Patients sometimes can't afford the co-payment or there is a problem with their [drug] insurance," she says. "They may just quietly stop taking their biologic, and then they tell you that after the psoriasis flares up."

    ALSO READ: Evidence-based guidance for psoriasis treatment

    Patients may also stop their therapy because they experience clearance of their psoriasis and decide on their own that they no longer need biologic therapy, notes Dr. Gooderham.

    Dr. Gooderham cites the Multinational Assessment of Psoriasis and Psoriatic Arthritis Survey, which found that respondents said they most often stopped their biologic therapy because of safety/tolerability issues and a lack or loss of efficacy of therapy.1

    The challenge in looking at recapturing efficacy if biologic therapy is not continuous is that studies have not been standardized, says Dr. Gooderham.

    "The trials have been done differently, so more work needs to be done before we can draw meaningful conclusions," says Dr. Gooderham.

    NEXT: Favorable response

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