455 Evolution of patient characteristics and treatment effectiveness in the real-world cohort of the Austrian psoriasis registry over a timespan of 18 years since the millenium

Introduction: Over the years, newly introduced anti-psoriatic treatments have provided excellent treatment response to a large number of patients in clinical trials. We analyzed to which extent this has led to an overall improvement in the real-world patient cohort of the Austrian Psoriasis Registry (PsoRA). Methods: Patient characteristics and treatment effectiveness in terms of PASI responses were analyzed in biologic-naïve patients during the first year of treatment since April 2004 until now, irrespective of treatment switches. Results: Data of 2729 patients were eligible for this analysis. The proportion of women significantly increased over the years from 29.9 to 36.2% (p<0.028), while the number of patients with psoriatic arthritis declined from 36.6 to 30.0% (p<0.001). Moreover, the duration of psoriatic disease at biologic treatment start continuously decreased from a mean (SD) of 20.5 (11.1) to 15.9 (12.9) years (p<0.001) and PASI decreased from 17.9 (8.4) to 9.0 (7.4). PASI100 response increased from 11.7 to 38.5% at 3 months and from 22.7 to 47.6% at 12 months after treatment start. PASI90 rates increased in a similar fashion from 22.0 to 61.0% at 3 months, and from 39.8 to 67.6% at 12 months after treatment start. Conclusion: The increased availability of highly effective drugs was associated with changes in patient characteristics and has led to improvements in treatment responses in real-word patients, however, one out of three or four patients, depending on the endpoint nowadays still does not achieve an entirely satisfactory treatment response (i.e. PASI90 or PASI < 3).