Pustular flare risk identified after stopping biologics in psoriasis

A multicenter study of 1,198 biologic treatment episodes in psoriasis patients found that a distinct pustular psoriasis flare occurred after biologic withdrawal in 7.2% of episodes, marked by painful, diffuse erythema with pustules and swelling mainly on the lower limbs. The study reported that family history of psoriasis, concomitant psoriatic arthritis, prior flare episodes, more withdrawal-relapse cycles, and slower PASI 50 response during therapy were independently associated with this flare pattern, and that flare occurrence increased with repeated withdrawal-relapse cycles.

Most relevant for: Patients with plaque psoriasis who are discontinuing biologic therapy, particularly those with psoriatic arthritis or a family history of psoriasis.

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