Drug survival of biological therapy is showing class effect: updated results from Slovenian National Registry of psoriasis

Abstract

Background Drug survival is an important measure of successful treatment of patients with chronic diseases such as psoriasis. Therefore, the objective was to calculate drug survival and examine safety profile of biologics and immunomodulators (adalimumab, apremilast, etanercept, ixekizumab, infliximab, secukinumab, and ustekinumab) from the Slovenian National Registry of patients with moderate‐to‐severe psoriasis. Methods Data about the patients with moderate‐to‐severe plaque psoriasis treated with biologics were collected from 2005 until July 2018. Kaplan‐Meier survival curves and Cox regression were used to calculate drug survival, where ustekinumab was selected as a reference. Results Overall, 1,606 patients were analyzed within 2,241 treatment episodes; adalimumab N = 831, apremilast N = 94, etanercept N = 101, ixekizumab N = 98, infliximab N = 164, secukinumab N = 340, and ustekinumab N = 613, respectively. Loss of efficacy was the most frequent reason for treatment discontinuation (contributing to 66.1% of all discontinuations). Ustekinumab was associated with the highest drug survival, meanwhile apremilast was the drug with the lowest survival rate compared to all others. Both IL‐17 inhibitors, secukinumab and ixekizumab, showed similar survival rate. Conclusions Ustekinumab was associated with the highest drug survival and most favorable safety profile compared to other biologics. Drug survival rates can be associated with the class effect of biological targets. Highest survival rate was observed for IL‐12/23 inhibitor, followed by IL‐17 and TNF‐α inhibitors, and last by an immunomodulator such as apremilast. Adverse events occurred most frequently with TNF‐α inhibitors.

Comparative study of the efficacy and safety of secukinumab vs ixekizumab in moderate‐to‐severe psoriasis after 1 year of treatment: Real‐world practice

“…The results were similar to those previously reported by other studies, with a lower survival in those patients with prior biologic failure, as expected. Lunder et al, based on the national psoriasis registry of Slovenia, also found a similar survival for both anti‐IL‐17 drugs, although it was lower than that achieved by Ustekinumab, suggesting a survival profile common to both, dependent on class. Egeberg et al, based on a national cohort in Denmark, found similar 12‐month survival figures of 84.23% for secukinumab and 87.02% for ixekizumab.…”

Ixekizumab vs ustekinumab for skin clearance in patients with moderate to severe psoriasis after a year of treatment: Real‐world practice

“…In terms of survival analysis, the largest published comparative study is the one conducted with the Slovenian national psoriasis registry, with 613 patients treated with ustekinumab and 98 with ixekizumab 45 . In this study, ustekinumab achieved significantly longer survival rates than the other included drugs, followed by IL‐17 inhibitors (ixekizumab and secukinumab) and anti‐TNF drugs.…”

Early prescription of biological agents for immune-mediated inflammatory diseases: opportunities and prospects. An expert’s opinion

“…difficile) [104][105][106][107]. Доказана более высокая «выживаемость» терапии устекинумабом по сравнению с другими ГИБП (ингибиторы ФНОα и ИЛ17, ведолизумаб) у пациентов с Пс и ПсА, ВЗК [108][109][110][111][112][113][114][115][116]. Раннее ингибирование ИЛ23 устекинумабом способствует уменьшению субклинических воспалительных изменений в энтезисах у пациентов с Пс в течение 12 нед терапии, при этом данный эффект сохраняется и к 52-й неделе лечения [117].…”