Eva Vilarrasa1, Jaume Notario2, Xavier Bordas2, Anna López-Ferrer1, Ignasi J Gich3, Lluís Puig4. 1. Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. 2. Department of Dermatology, Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain. 3. Department of Clinical Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. 4. Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: llpuig@santpau.cat.
Abstract
BACKGROUND: Biologic drug survival in psoriasis reflects long-term performance in real-life settings. Previous studies have yielded inconsistent results. OBJECTIVES: We sought to analyze long-term biologic survival and its associated variables in a large, real-life cohort of patients with moderate to severe chronic plaque psoriasis. METHODS: This was an observational retrospective study. Data were extracted from clinical records of 427 patients treated with biologic agents over a 4-year period. Drug survival was analyzed using the Kaplan-Meier method and the influence of several covariates was assessed using Cox regression. RESULTS: We analyzed 703 treatment courses. Overall median drug survival was 31.0 months. Cumulative probability of drug survival was lower in obese patients (23.0 months, 95% confidence interval 17.4-28.6) than in patients with body mass index less than 30 (37.3 months, 95% confidence interval 29.4-45.1, P = .001), and it was significantly higher for ustekinumab than for any other biologic agent (log rank test P < .001). Multivariate analysis showed that obesity, etanercept treatment, and strict adherence to approved doses were associated with an increased probability of drug withdrawal, whereas ustekinumab treatment, and PASI75 and PASI90 responses at week 16 prolonged drug survival. LIMITATIONS: Data were collected retrospectively. CONCLUSIONS: These findings can facilitate the daily treatment of psoriatic patients and promote long-term effectiveness of biologic therapies.
BACKGROUND: Biologic drug survival in psoriasis reflects long-term performance in real-life settings. Previous studies have yielded inconsistent results. OBJECTIVES: We sought to analyze long-term biologic survival and its associated variables in a large, real-life cohort of patients with moderate to severe chronic plaque psoriasis. METHODS: This was an observational retrospective study. Data were extracted from clinical records of 427 patients treated with biologic agents over a 4-year period. Drug survival was analyzed using the Kaplan-Meier method and the influence of several covariates was assessed using Cox regression. RESULTS: We analyzed 703 treatment courses. Overall median drug survival was 31.0 months. Cumulative probability of drug survival was lower in obesepatients (23.0 months, 95% confidence interval 17.4-28.6) than in patients with body mass index less than 30 (37.3 months, 95% confidence interval 29.4-45.1, P = .001), and it was significantly higher for ustekinumab than for any other biologic agent (log rank test P < .001). Multivariate analysis showed that obesity, etanercept treatment, and strict adherence to approved doses were associated with an increased probability of drug withdrawal, whereas ustekinumab treatment, and PASI75 and PASI90 responses at week 16 prolonged drug survival. LIMITATIONS: Data were collected retrospectively. CONCLUSIONS: These findings can facilitate the daily treatment of psoriaticpatients and promote long-term effectiveness of biologic therapies.
Authors: L J van Vugt; J M P A van den Reek; E Meulewaeter; M Hakobjan; N Heddes; T Traks; K Kingo; M Galluzzo; M Talamonti; J Lambert; M J H Coenen; E M G J de Jong Journal: J Eur Acad Dermatol Venereol Date: 2019-08-05 Impact factor: 6.166
Authors: Kirk Geale; Ingrid Lindberg; Emma C Paulsson; E Christina M Wennerström; Anna Tjärnlund; Wim Noel; Dana Enkusson; Elke Theander Journal: Rheumatol Adv Pract Date: 2020-12-19
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