Biological therapies for psoriasis: Adherence and outcome analysis from a clinical perspective

Ross, Christopher A.; Marshman, Gillian; Grillo, Marianne; Stanford, Tyman

doi:10.1111/ajd.12294

Cited by 31 publications

(41 citation statements)

References 12 publications

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“…Biologic agents have shown relatively good adherence rates, ranging from 58% to 100%, which is higher than the adherence rates reported for oral therapy . In two trials including only psoriasis patients, ustekinumab showed the best overall adherence rate among systemic therapies studied (acitretin, methotrexate, adalimumab, etanercept, infliximab) . Comparing the adherence rates of different anti‐tumour necrosis factor alpha agents, infliximab had better results than adalimumab and etanercept .…”

Section: Factors Influencing Treatment Adherencementioning

confidence: 88%

A systematic review of factors influencing treatment adherence in chronic inflammatory skin disease – strategies for optimizing treatment outcome

Eicher

Knop

Aszodi

et al. 2019

Acad Dermatol Venereol

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Adherence describes how a patient follows a medical regime recommended by a healthcare provider. Poor treatment adherence represents a complex and challenging problem of international healthcare systems, as it has a substantial impact on clinical outcomes and patient safety and constitutes an important financial burden. Since it is one of the most common causes of treatment failure, it is extremely important for physicians to reliably distinguish between non‐adherence and non‐response. This systematic review aims to summarize the current literature on treatment adherence in dermatology, focusing on chronic inflammatory skin diseases such as psoriasis, atopic dermatitis and acne. A systematic literature search was performed using the PubMed Database, including articles from 2008 to 2018. Low treatment adherence is a multidimensional phenomenon defined by the interplay of numerous factors and should under no circumstances be considered as the patient's fault alone. Factors influencing treatment adherence in dermatology include patient characteristics and beliefs, treatment efficacy and duration, administration routes, disease chronicity and the disease itself. Moreover, the quality of the physician‐patient relationship including physician‐time available for the patient plays an important role. Understanding patients’ adherence patterns and the main drivers of non‐adherence creates opportunities to improve adherence in the future. Strategies to increase treatment adherence range from reminder programs to simplifying prescriptions or educational interventions. Absolute adherence to treatment may not be realistically achievable, but efforts need to be made to raise awareness in order to maximize adherence as far as possible.

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Section: Factors Influencing Treatment Adherencementioning

confidence: 88%

A systematic review of factors influencing treatment adherence in chronic inflammatory skin disease – strategies for optimizing treatment outcome

Eicher

Knop

Aszodi

et al. 2019

Acad Dermatol Venereol

View full text Add to dashboard Cite

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“…Nevertheless, until recently, there was only a lack of data obtained on large patient population treated for long time with TNF-alpha inhibitors and IL-12/23 inhibitor in the real-life settings (11,15). Table 3 summarizes all the studies published so far, where data were collected from large patient population of two or more centers, the follow-up period was at least one year, and the authors compared at least three or more biological therapies.…”

Section: Discussionmentioning

confidence: 99%

Long-term drug survival and predictor analysis of the whole psoriatic patient population on biological therapy in Hungary

Pogácsás

Borsi

Takács

et al. 2017

Journal of Dermatological Treatment

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Persistence is an important component of therapeutic success, which depends on a variety of factors. Persistence measured under optimal conditions during clinical trials does not necessarily coincide with persistence observed in the real-world settings. The aim of the present study was to compare persistence rate of TNF-alpha inhibitors and interleukin 12/23 inhibitor in all psoriasis patients in Hungary, as well as to analyze the predictors of persistence. Data collected from 1263 patients over a period of 46 months were subjected to a retrospective analysis. Drug survival rate has been calculated according to Kaplan-Meier analysis and Cox regression was used to study the predictors. The overall persistence rate for the four biologicals exceeded 60% after 3 years. The persistence rate of ustekinumab at 3 years was 67.83%, which was superior compared to that of the TNF-alpha inhibitors, where the mean persistence rate was shown to be 50.76% (p < .05). Male patients showed significantly higher persistence than females (HR ¼ .76, p < .05 CI: 0.63, 0.92). Age, therapy-naïve status and use of concomitant MTX did not have significant effect on drug survival. Persistence rate of ustekinumab was significantly higher than that of TNF-alpha inhibitors, and among predictors, only male gender influenced persistence significantly. ARTICLE HISTORY

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“…Biologics that have prolonged drug survival rates are associated with superior efficacy and safety profiles . In addition, prolonged treatment adherence is noted as a surrogate measure for treatment success . The predictive factors for survival of biologics remain unclear, as no pooled analysis of these data has, to our knowledge, been performed yet.…”

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confidence: 99%

Factors predicting persistence of biologic drugs in psoriasis: a systematic review and meta‐analysis

et al. 2019

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Summary Background Long‐term therapy for psoriasis is impaired by gradual loss of effectiveness and treatment discontinuation. Identifying factors that affect biologic drug survival may help in treatment optimization. Objectives To identify factors that predicted biologic drug persistence or discontinuation in a real‐life setting. Methods We identified studies of biologic persistence in psoriasis through a comprehensive, systematic literature search using predefined search criteria. Studies were screened by title and abstract then further by full‐text review. Hazard ratio (HR) data were extracted for all available predictive factors (HRs > 1 denoted biologic discontinuation, and HRs < 1 denoted biologic persistence). A meta‐analysis of HRs (random‐effects model) was used to assess any predictive factor included in at least two studies. Results Sixteen cohort studies were included in the review, with a total of 32 194 patients. A meta‐analysis was performed on 13 studies (n = 29 802): nine for female sex (n = 28 090), six for obesity (n = 9311) and six for psoriatic arthritis (n = 24 444). Obesity and female sex predicted treatment discontinuation, with HRs of 1.21 [95% confidence interval (CI) 1.10–1.32, I2 = 0%] and 1.22 (95% CI 1.07–1.38, I2 = 84%), respectively. Concomitant psoriatic arthritis predicted biologic persistence (HR 0.83, 95% CI 0.80–0.86, I2 = 0%). Female sex predicted biologic discontinuation due to side‐effects, with a pooled HR of 2.16 (95% CI 1.39–3.35, I2 = 67%). Other reported predictive factors (smoking, metabolic syndrome, biologic naivety, age, Dermatology Life Quality Index, dyslipidaemia, high socioeconomic status and concomitant methotrexate) were insufficiently reported for meta‐analysis. Conclusions Our meta‐analysis demonstrates that female sex and obesity predict biologic discontinuation, and concomitant psoriatic arthritis predicts biologic survival. What's already known about this topic? Ineffectiveness is the main factor that causes drug discontinuation during long‐term treatment of psoriasis. It is unclear which factors and comorbidities impact drug persistence. What does this study add? Female sex and obesity predict biologic discontinuation due to ineffectiveness and adverse events. Concomitant psoriatic arthritis is associated with improved drug persistence.

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Biological therapies for psoriasis: Adherence and outcome analysis from a clinical perspective

Cited by 31 publications

References 12 publications

A systematic review of factors influencing treatment adherence in chronic inflammatory skin disease – strategies for optimizing treatment outcome

A systematic review of factors influencing treatment adherence in chronic inflammatory skin disease – strategies for optimizing treatment outcome

Long-term drug survival and predictor analysis of the whole psoriatic patient population on biological therapy in Hungary

Factors predicting persistence of biologic drugs in psoriasis: a systematic review and meta‐analysis

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