J Zweegers1, J M P A van den Reek1, P C M van de Kerkhof1, M E Otero1, A L A Kuijpers2, M I A Koetsier3, W P Arnold4, M A M Berends5, L Weppner-Parren6, P M Ossenkoppele7, M D Njoo7, J M Mommers8, P P M van Lümig1, R J B Driessen1, W Kievit9, E M G J de Jong1,10. 1. Department of Dermatology, Biostatistics and Health Technology Assessment, Radboud University Medical Center, Nijmegen, the Netherlands. 2. Maxima Medisch Centrum, Eindhoven/Veldhoven, the Netherlands. 3. Gelre Ziekenhuizen, Apeldoorn, the Netherlands. 4. Ziekenhuis Gelderse Vallei, Ede, the Netherlands. 5. Slingeland Ziekenhuis, Doetinchem, the Netherlands. 6. Jeroen Bosch Ziekenhuis, Den Bosch, the Netherlands. 7. Ziekenhuisgroep Twente, Almelo, Hengelo, the Netherlands. 8. St Anna Ziekenhuis, Geldrop, the Netherlands. 9. Department of Epidemiology, Biostatistics and Health Technology Assessment, Radboud University Medical Center, Nijmegen, the Netherlands. 10. Radboud University, Nijmegen, the Netherlands.
Abstract
BACKGROUND: Predictors for successful treatment are important for personalized medicine. Predictors for drug survival of biologics in psoriasis have been assessed, but not split for different biologics or for the reason of discontinuation. OBJECTIVES: To compare long-term drug survival between the outpatient biologics adalimumab, etanercept and ustekinumab in patients with psoriasis, and to elucidate predictors for overall survival and drug discontinuation due to ineffectiveness and side-effects for each biologic separately. METHODS: Ten years of data were extracted from the prospective, multicentre, long-term BioCAPTURE registry. Kaplan-Meier survival analyses and confounder-corrected multivariate Cox regression analysis for drug survival (MCR-DS) were performed to compare drug survival between biologics. To elucidate the predictors for different reasons of discontinuation for each biologic, univariate Cox regression analyses and multivariate Cox regression analyses for predictors (MCR-P) with backward selection were performed. RESULTS: In total, 526 treatment episodes - 186 adalimumab, 238 etanercept and 102 ustekinumab - were included covering 1333 treatment years. MCR-DS showed a significantly higher overall survival for ustekinumab compared with adalimumab and etanercept. MCR-P showed that higher body mass index (BMI) was a predictor for discontinuation due to ineffectiveness for etanercept and ustekinumab and that female sex was a predictor for discontinuation due to side-effects for adalimumab, etanercept and ustekinumab. CONCLUSIONS: Ustekinumab has the highest confounder-corrected long-term drug survival in psoriasis treatment, compared with adalimumab and etanercept. Higher BMI is a predictor for discontinuation due to ineffectiveness in etanercept and ustekinumab, and female sex is a consistent predictor for discontinuation due to side-effects in all three outpatient biologics.
BACKGROUND: Predictors for successful treatment are important for personalized medicine. Predictors for drug survival of biologics in psoriasis have been assessed, but not split for different biologics or for the reason of discontinuation. OBJECTIVES: To compare long-term drug survival between the outpatient biologics adalimumab, etanercept and ustekinumab in patients with psoriasis, and to elucidate predictors for overall survival and drug discontinuation due to ineffectiveness and side-effects for each biologic separately. METHODS: Ten years of data were extracted from the prospective, multicentre, long-term BioCAPTURE registry. Kaplan-Meier survival analyses and confounder-corrected multivariate Cox regression analysis for drug survival (MCR-DS) were performed to compare drug survival between biologics. To elucidate the predictors for different reasons of discontinuation for each biologic, univariate Cox regression analyses and multivariate Cox regression analyses for predictors (MCR-P) with backward selection were performed. RESULTS: In total, 526 treatment episodes - 186 adalimumab, 238 etanercept and 102 ustekinumab - were included covering 1333 treatment years. MCR-DS showed a significantly higher overall survival for ustekinumab compared with adalimumab and etanercept. MCR-P showed that higher body mass index (BMI) was a predictor for discontinuation due to ineffectiveness for etanercept and ustekinumab and that female sex was a predictor for discontinuation due to side-effects for adalimumab, etanercept and ustekinumab. CONCLUSIONS:Ustekinumab has the highest confounder-corrected long-term drug survival in psoriasis treatment, compared with adalimumab and etanercept. Higher BMI is a predictor for discontinuation due to ineffectiveness in etanercept and ustekinumab, and female sex is a consistent predictor for discontinuation due to side-effects in all three outpatient biologics.
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Authors: Siddharth Singh; Antonio Facciorusso; Abha G Singh; Niels Vande Casteele; Amir Zarrinpar; Larry J Prokop; Eduardo L Grunvald; Jeffrey R Curtis; William J Sandborn Journal: PLoS One Date: 2018-05-17 Impact factor: 3.240