Guy Shalom1, Arnon D Cohen2, Michael Ziv3, Cohen Barak Eran3, Ilan Feldhamer4, Tamar Freud5, Eitan Berman6, Shirley Oren7, Emmilia Hodak8, Lev Pavlovsky9. 1. Department of Dermatology and Venereology, Soroka Medical Center, Beer-Sheva, Israel; Division of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: Guyshal@bgu.ac.il. 2. Department of Research and Information, Chief Physician Office, Clalit Health Services, Tel Aviv, Israel; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. 3. Department of Dermatology, Haemek Medical Center, Afula, Israel. 4. Chief Physician's Office, Department of Quality Measurements and Research, Clalit Health Services, Tel Aviv, Israel. 5. Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. 6. Department of Dermatology and Venereology, Soroka Medical Center, Beer-Sheva, Israel. 7. Rheumatology Unit, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel. 8. Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 9. Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel. Electronic address: levpav@gmail.com.
Abstract
BACKGROUND: Drug survival is defined as the time period of treatment with a certain drug until its cessation. The role of previous exposure to traditional systemic treatments in biologic survival is still unknown. OBJECTIVE: To investigate the drug survival rates of biologic treatments in patients with psoriasis and to identify predictor factors. METHODS: Survival analysis was performed on patients with severe psoriasis who received adalimumab, infliximab, etanercept, and ustekinumab for treatment of psoriasis, drawn from the Clalit Health Services database. Multivariate analysis was performed adjusting for demographic variables; metabolic syndrome and its components; psoriatic arthritis; biologic naivety; coadministration of methotrexate, acitretin, or cyclosporine; and previous standard systemic treatment exposure. RESULTS: Among 907 patients treated with 1575 biologic treatments, ustekinumab had a significantly higher survival rate than tumor necrosis factor inhibitors. Biologic naivety and concomitant methotrexate intake were positive predictors for drug survival, whereas the female sex and the duration of previous systemic treatments were negative predictors. LIMITATIONS: Data regarding disease severity or duration could not be drawn from the Clalit Health Services database. CONCLUSION: Ustekinumab had better retention rates in comparison with other investigated biologics in patients with severe psoriasis, most of whom used it as a third line therapy.
BACKGROUND: Drug survival is defined as the time period of treatment with a certain drug until its cessation. The role of previous exposure to traditional systemic treatments in biologic survival is still unknown. OBJECTIVE: To investigate the drug survival rates of biologic treatments in patients with psoriasis and to identify predictor factors. METHODS: Survival analysis was performed on patients with severe psoriasis who received adalimumab, infliximab, etanercept, and ustekinumab for treatment of psoriasis, drawn from the Clalit Health Services database. Multivariate analysis was performed adjusting for demographic variables; metabolic syndrome and its components; psoriatic arthritis; biologic naivety; coadministration of methotrexate, acitretin, or cyclosporine; and previous standard systemic treatment exposure. RESULTS: Among 907 patients treated with 1575 biologic treatments, ustekinumab had a significantly higher survival rate than tumor necrosis factor inhibitors. Biologic naivety and concomitant methotrexate intake were positive predictors for drug survival, whereas the female sex and the duration of previous systemic treatments were negative predictors. LIMITATIONS: Data regarding disease severity or duration could not be drawn from the Clalit Health Services database. CONCLUSION:Ustekinumab had better retention rates in comparison with other investigated biologics in patients with severe psoriasis, most of whom used it as a third line therapy.
Authors: Megan H. Noe; Daniel B. Shin; Jalpa A. Doshi; David J. Margolis; Joel M. Gelfand Journal: J Drugs Dermatol Date: 2019-08-01 Impact factor: 2.114
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