Tiago Torres1,2, Luis Puig3, Ron Vender4, Charles Lynde5, Stefano Piaserico6, Jose M Carrascosa7, Paolo Gisondi8, Esteban Daudén9, Curdin Conrad10, Pedro Mendes-Bastos11, Paulo Ferreira11, Luiz Leite12, Justin D Lu13, J Valerio12, M Bruni8, F Messina6, A Nidegger10, M Llamas-Velasco9, E Del Alcazar7, A Mufti14, Kyra White5, G Caldarola15,16, Laetitia Teixeira17, Paolo Romanelli18, K Desai18, Spyridon Gkalpakiotis19, Marco Romanelli20, Jensen Yeung14, Miguel Nogueira21, Andrea Chiricozzi15,16. 1. Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal. torres.tiago@outlook.com. 2. Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal. torres.tiago@outlook.com. 3. Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 4. McMaster University, Hamilton, Ontario, Canada. 5. Lynde Institute for Dermatology, Markham, Ontario, Canada. 6. Dermatology Unit, Department of Medicine, University of Padua, 35128, Padua, Italy. 7. Department of Dermatology, Germans Trias i Pujol University Hospital (HUGTP), Autonomous University of Barcelona (UAB), Badalona, Spain. 8. Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37126, Verona, Italy. 9. Dermatology Department, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain. 10. Department of Dermatology, Lausanne University Hospital CHUV, University of Lausanne, Lausanne, Switzerland. 11. Hospital CUF Descobertas, Lisbon, Portugal. 12. Clínica Médica Belém, Lisbon, Portugal. 13. Michael G. DeGroote School of Medicine, Faculty of Medicine, Hamilton, Ontario, Canada. 14. Division of Dermatology, Department of Medicine, University of Toronto, Probity Medical Research, Waterloo, Ontario, Canada. 15. Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 16. Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168, Rome, Italy. 17. Center for Health Technology and Services Research (CINTESIS), Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS.UP), Porto, Portugal. 18. Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida, USA. 19. Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic. 20. Department of Dermatology, University of Pisa, Pisa, Italy. 21. Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Abstract
BACKGROUND: Drug survival analysis of biologic agents in psoriasis is of extreme importance, as it allows not only the evaluation of objective clinical outcomes (such as effectiveness and safety) but also of factors that are associated with patients' adherence to treatment. The aim of this study was to evaluate and compare the drug survival of the most recent biologic agents approved for the treatment of moderate-to-severe psoriasis-ustekinumab, secukinumab, ixekizumab, brodalumab, guselkumab, and risankizumab-and to identify clinical predictors that can influence the drug survival of these drugs. METHODS: This retrospective multicentric cohort study from 16 dermatology centers in Portugal, Spain, Italy, Switzerland, Czech Republic, Canada, and the United States included patients that started IL-12/23, IL-17 (IL-17A and IL-17R) and IL-23 inhibitors for the treatment of psoriasis between January 1, 2012 and December 31, 2019. Survival analysis was performed using a Kaplan-Meier estimator, to obtain descriptive survival curves, and proportional hazard Cox regression models. RESULTS: A total of 3312 treatment courses (total patients: 3145) were included in the study; 1118 (33.8%) with an IL-12/23 inhibitor (ustekinumab), 1678 (50.7%) with an IL-17 inhibitor [911 (27.5%) on secukinumab, 651 (19.7%) on ixekizumab, 116 (3.5%) on brodalumab], and 516 (15.5%) with an IL-23 inhibitor [398 (12.0%) on guselkumab, 118 (3.5%) on risankizumab]. At 18 months, the cumulative probability of survival was 96.4% for risankizumab, 91.1% for guselkumab, 86.3% for brodalumab, 86.1% for ustekinumab, 82.0% for ixekizumab, and 79.9% for secukinumab. Using ustekinumab as reference, drug survival of guselkumab was higher (HR 0.609; 95% CI 0.418-0.887) and that of secukinumab was lower (HR 1.490; 95% CI 1.257-1.766). In the final multivariable model, secukinumab, female sex, higher BMI, and prior exposure to biologic agents significantly increased the risk of drug discontinuation, whereas risankizumab was protective. CONCLUSION: In this multinational cohort with 8439 patient-years of follow-up, the cumulative probability of drug survival for all drugs was >79% at 18 months. Prescribed biologic, female sex, higher BMI, and previous exposure to biologic agents were predictors of drug discontinuation. Drug survival of guselkumab and risankizumab was higher than that of ustekinumab, and secukinumab was lower.
BACKGROUND: Drug survival analysis of biologic agents in psoriasis is of extreme importance, as it allows not only the evaluation of objective clinical outcomes (such as effectiveness and safety) but also of factors that are associated with patients' adherence to treatment. The aim of this study was to evaluate and compare the drug survival of the most recent biologic agents approved for the treatment of moderate-to-severe psoriasis-ustekinumab, secukinumab, ixekizumab, brodalumab, guselkumab, and risankizumab-and to identify clinical predictors that can influence the drug survival of these drugs. METHODS: This retrospective multicentric cohort study from 16 dermatology centers in Portugal, Spain, Italy, Switzerland, Czech Republic, Canada, and the United States included patients that started IL-12/23, IL-17 (IL-17A and IL-17R) and IL-23 inhibitors for the treatment of psoriasis between January 1, 2012 and December 31, 2019. Survival analysis was performed using a Kaplan-Meier estimator, to obtain descriptive survival curves, and proportional hazard Cox regression models. RESULTS: A total of 3312 treatment courses (total patients: 3145) were included in the study; 1118 (33.8%) with an IL-12/23 inhibitor (ustekinumab), 1678 (50.7%) with an IL-17 inhibitor [911 (27.5%) on secukinumab, 651 (19.7%) on ixekizumab, 116 (3.5%) on brodalumab], and 516 (15.5%) with an IL-23 inhibitor [398 (12.0%) on guselkumab, 118 (3.5%) on risankizumab]. At 18 months, the cumulative probability of survival was 96.4% for risankizumab, 91.1% for guselkumab, 86.3% for brodalumab, 86.1% for ustekinumab, 82.0% for ixekizumab, and 79.9% for secukinumab. Using ustekinumab as reference, drug survival of guselkumab was higher (HR 0.609; 95% CI 0.418-0.887) and that of secukinumab was lower (HR 1.490; 95% CI 1.257-1.766). In the final multivariable model, secukinumab, female sex, higher BMI, and prior exposure to biologic agents significantly increased the risk of drug discontinuation, whereas risankizumab was protective. CONCLUSION: In this multinational cohort with 8439 patient-years of follow-up, the cumulative probability of drug survival for all drugs was >79% at 18 months. Prescribed biologic, female sex, higher BMI, and previous exposure to biologic agents were predictors of drug discontinuation. Drug survival of guselkumab and risankizumab was higher than that of ustekinumab, and secukinumab was lower.
Authors: Grigory A Manyak; Nidhi H Patel; Amit K Dey; Maryia Svirydava; Philip M Parel; Heather L Teague; Alexander V Sorokin; Meron Teklu; Wunan Zhou; Martin P Playford; Nehal N Mehta Journal: J Invest Dermatol Date: 2021-11-29 Impact factor: 7.590
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: April W Armstrong; Ahmed M Soliman; Keith A Betts; Yan Wang; Yawen Gao; Vassilis Stakias; Luis Puig Journal: Dermatol Ther (Heidelb) Date: 2021-12-04
Authors: Jessica A Walsh; Kristina Callis Duffin; Abby S Van Voorhees; Soumya D Chakravarty; Timothy Fitzgerald; Amanda Teeple; Katelyn Rowland; Jonathan Uy; Robert R McLean; Wendi Malley; Angel Cronin; Joseph F Merola Journal: Dermatol Ther (Heidelb) Date: 2021-11-25
Authors: Federico Pirro; Giacomo Caldarola; Andrea Chiricozzi; Martina Burlando; Marco Mariani; Aurora Parodi; Ketty Peris; Clara De Simone Journal: Clin Drug Investig Date: 2021-09-18 Impact factor: 2.859