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Real-World Effects of Biologics on Renal Function in Psoriatic Patients: A Retrospective Study

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Abstract

Background

Patients with severe psoriasis are prone to deterioration of renal function. Whether biologics with potent anti-inflammatory action can prevent deterioration of renal function in psoriatic patients was unclear.

Objective

To investigate the effects of different biologics on renal function in patients with severe psoriasis.

Methods

By using the Chang Gung Research Database in Taiwan during 2006–2018, we analyzed the changes in renal function of psoriatic patients from 2 years before biologic treatments to baseline (start of biologic treatment) to after 2 years’ treatment with different classes of biologics (anti-TNF, anti-IL-12/23, and anti-IL-17 agents). The renal function was evaluated by estimated glomerular filtration rate (eGFR) and the staging of chronic kidney disease (CKD). We further analyzed the risk factors of progression on the staging of CKD during biologics treatment.

Results

We included 601 patients with severe psoriasis receiving continuous use of biologics for ≥ 2 years. We detected no significant differences between pre-biologic treatment with conventional systemic treatment and post-biologic treatment in the levels of eGFR and progression of CKD staging among psoriatic patients receiving different classes of biologics. Most patients (97.8%) remained at stable CKD stage, while progression of CKD stage over time occurred in 13 patients (2.2%), with seven treated with anti-TNF biologics and six treated with anti-IL-12/23 biologics. Of note, all 52 patients receiving anti-IL-17 biologics had stable CKD. Progression of CKD during biologics use was associated with lower baseline levels of eGFR, higher baseline CKD stage, older age, diabetes, and dyslipidemia. Further multiple logistic regression analysis showed diabetes as an independent factor for the deterioration of renal function during biologic treatment.

Conclusions

Biologic treatments failed to improve but did not worsen renal function of psoriatic patients during a 2-year follow-up period. Diabetes is an important risk factor for the deterioration of renal function.

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Acknowledgements

The authors acknowledge the support of the Maintenance Project of the Center for Big Data Analytics and Statistics (CLRPG3D0048) at Chang Gung Memorial Hospital, Linkou for statistical consultation and data analysis.

Author information

Authors and Affiliations

  1. Department of Dermatology, Chang Gung Memorial Hospital, Linkou, 5, Fuxing St, Guishan Dist, Taoyuan, 33305, Taiwan

    Chun-Bing Chen & Ching-Chi Chi

  2. School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Chun-Bing Chen, Ching-Chung Hsiao, Shang-Hung Chang & Ching-Chi Chi

  3. Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan

    Chun-Bing Chen

  4. Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Chun-Bing Chen

  5. Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan

    Chun-Bing Chen

  6. Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan

    Chun-Bing Chen

  7. Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan

    Chun-Bing Chen

  8. Department of Dermatology, Xiamen Chang Gung Memorial Hospital, Xiamen, China

    Chun-Bing Chen

  9. School of Medicine, National Tsing Hua University, Hsinchu, Taiwan

    Chun-Bing Chen

  10. Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan

    Yu-Tung Huang & Shang-Hung Chang

  11. Division of Nephrology, Department of Internal Medicine, New Taipei Municipal TuCheng Hospital, New Taipei, Taiwan

    Ching-Chung Hsiao

  12. Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan

    Shang-Hung Chang

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  1. Chun-Bing Chen
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Corresponding author

Correspondence to Ching-Chi Chi.

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Funding

This study was supported by research grants from the Chang Gung Memorial Hospital, Linkou, Taiwan (CORPG3J0061). The funder played no role in study design, data collection, data analysis, manuscript preparation, and publication decisions.

Data availability statement

The data used for this study are available from the corresponding author on reasonable request.

Conflicts of interest

None.

Ethics approval

This study was approved by the Institutional Review Board of Chang Gung Medical Foundation (IRB. NO. 201802089B0C502).

Consent to participate

Not applicable.

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Not applicable.

Code availability:

Not applicable.

Author contributions

CBC, TYH, CCH, SHC, and CCC had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: CBC, CCH, SHC, and CCC. Acquisition, analysis, or interpretation of data: All authors. Drafting of the manuscript: CBC, TYH, CCH, and CCC. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: CBC, TYH, SHC, and CCC. Obtained funding: SHC, and CCC. Study supervision: CCC.

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Chen, CB., Huang, YT., Hsiao, CC. et al. Real-World Effects of Biologics on Renal Function in Psoriatic Patients: A Retrospective Study. BioDrugs 36, 657–666 (2022). https://doi.org/10.1007/s40259-022-00547-5

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  • DOI: https://doi.org/10.1007/s40259-022-00547-5

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