T Graier1, W Salmhofer1, C Jonak2, W Weger1, C Kölli3, B Gruber4, P G Sator5, K Prillinger6, A Mlynek7, M Schütz-Bergmayr8, L Richter9, G Ratzinger10, C Painsi11, S Selhofer12, N Häring13, K Wippel-Slupetzky14, H Skvara3, H Trattner2, A Tanew2, M Inzinger1, R Tatarski12, C Bangert2, C Ellersdorfer9, R Lichem1, A Gruber-Wackernagel1, A Hofer1, F Legat1, E Schmiedberger15, R Strohal13, B Lange-Asschenfeldt11, M Schmuth10, I Vujic9, W Hoetzenecker8, F Trautinger6, W Saxinger4, R Müllegger3, F Quehenberger15, P Wolf1. 1. Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria. 2. Department of Dermatology, Medical University of Vienna, Vienna, Austria. 3. Department of Dermatology and Venereology, State Hospital, Wiener Neustadt, Austria. 4. Department of Dermatology and Venereology, Hospital of Wels-Grieskirchen, Wels-Grieskirchen, Austria. 5. Department of Dermatology, Hietzing Hospital, Vienna, Austria. 6. Department of Dermatology and Venereology, University Hospital St Pölten, St Pölten, Austria. 7. Department of Dermatology, Hospital of Elisabethinen, Linz, Austria. 8. Department of Dermatology and Venereology, Kepler University Hospital, Linz, Austria. 9. Department of Dermatology and Venereology, State Hospital of Vienna Rudolfstiftung, Vienna, Austria. 10. Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria. 11. Department of Dermatology and Venereology, State Hospital, Klagenfurt, Austria. 12. Department of Dermatology and Allergology, Paracelsus Medical University, Salzburg, Austria. 13. Department of Dermatology and Venereology, Federal Academic Teaching Hospital, Feldkirch, Austria. 14. Health Center Vienna-Nord, Vienna, Austria. 15. Institute for Medical Informatics, Statistics, and Documentation, Medical University of Graz, Graz, Austria.
Abstract
BACKGROUND: Drug survival rates reflect efficacy and safety and may be influenced by the availability of alternative treatment options. Little is known about time-dependent drug survival in psoriasis and the effect of increasing numbers of biologic treatment options. OBJECTIVES: To determine whether drug survival is influenced by the availability of treatment options and by factors such as gender, psoriatic arthritis or previous biologic treatment. METHODS: This observational, retrospective, multicentre cohort study analysed data from patients registered in the Austrian Psoriasis Registry (PsoRA) who were treated with biologics between 1 January 2015 and 30 November 2019. RESULTS: A total of 1572 patients who received 1848 treatment cycles were included in this analysis. The highest long-term Psoriasis Area and Severity Index improvement was observed after treatment with ixekizumab, followed by ustekinumab and secukinumab, adalimumab and etanercept. Overall, ustekinumab surpassed all other biologics in drug survival up to 48 months. However, when adjusted for biologic naïvety, its superiority vanished and drug survival rates were similar for ixekizumab (91·6%), secukinumab (90·2%) and ustekinumab (92·8%), all of them superior to adalimumab (76·5%) and etanercept (71·9%) at 12 months and beyond. Besides biologic non-naïvety (2·10, P < 0·001), the introduction of a new drug such as secukinumab or ixekizumab (relative hazard ratio 1·6, P = 0·001) and female gender (1·50, P = 0·019) increased the risk of treatment discontinuation overall, whereas psoriatic arthritis did not (1·12, P = 0·21). CONCLUSIONS: The time-dependent availability of drugs should be considered when analysing and comparing drug survival. Previous biologic exposure significantly influences drug survival. Women are more likely to stop treatment.
BACKGROUND: Drug survival rates reflect efficacy and safety and may be influenced by the availability of alternative treatment options. Little is known about time-dependent drug survival in psoriasis and the effect of increasing numbers of biologic treatment options. OBJECTIVES: To determine whether drug survival is influenced by the availability of treatment options and by factors such as gender, psoriatic arthritis or previous biologic treatment. METHODS: This observational, retrospective, multicentre cohort study analysed data from patients registered in the Austrian Psoriasis Registry (PsoRA) who were treated with biologics between 1 January 2015 and 30 November 2019. RESULTS: A total of 1572 patients who received 1848 treatment cycles were included in this analysis. The highest long-term Psoriasis Area and Severity Index improvement was observed after treatment with ixekizumab, followed by ustekinumab and secukinumab, adalimumab and etanercept. Overall, ustekinumab surpassed all other biologics in drug survival up to 48 months. However, when adjusted for biologic naïvety, its superiority vanished and drug survival rates were similar for ixekizumab (91·6%), secukinumab (90·2%) and ustekinumab (92·8%), all of them superior to adalimumab (76·5%) and etanercept (71·9%) at 12 months and beyond. Besides biologic non-naïvety (2·10, P < 0·001), the introduction of a new drug such as secukinumab or ixekizumab (relative hazard ratio 1·6, P = 0·001) and female gender (1·50, P = 0·019) increased the risk of treatment discontinuation overall, whereas psoriatic arthritis did not (1·12, P = 0·21). CONCLUSIONS: The time-dependent availability of drugs should be considered when analysing and comparing drug survival. Previous biologic exposure significantly influences drug survival. Women are more likely to stop treatment.
Authors: Tiago Torres; Luis Puig; Ron Vender; Jensen Yeung; José-Manuel Carrascosa; Stefano Piaserico; Paolo Gisondi; Charles Lynde; Paulo Ferreira; Pedro Mendes Bastos; Esteban Dauden; Luiz Leite; Joana Valerio; Elena Del Alcázar-Viladomiu; Eva Vilarrasa Rull; Mar Llamas-Velasco; Federico Pirro; Francesco Messina; Manfredo Bruni; Gaetano Licata; Federica Ricceri; Alessia Nidegger; Jan Hugo; Asfandyar Mufti; Athina-Ioanna Daponte; Laetitia Teixeira; Anna Balato; Marco Romanelli; Francesca Prignano; Spyridon Gkalpakiotis; Curdin Conrad; Elizabeth Lazaridou; Natalia Rompoti; Marina Papoutsaki; Miguel Nogueira; Andrea Chiricozzi Journal: Am J Clin Dermatol Date: 2022-08-17 Impact factor: 6.233
Authors: Francesco Bellinato; Paolo Gisondi; Elena Mason; Paolo Ricci; Martina Maurelli; Giampiero Girolomoni Journal: Dermatol Ther (Heidelb) Date: 2022-04-27
Authors: T Graier; W Weger; C Jonak; P Sator; C Zikeli; K Prillinger; C Sassmann; B Gruber; W Saxinger; G Ratzinger; C Painsi; A Mlynek; N Häring; B Sadoghi; H Trattner; R Müllegger; F Quehenberger; W Salmhofer; Peter Wolf Journal: Sci Rep Date: 2022-09-05 Impact factor: 4.996