Drug survival of biologics in treating psoriasis: a meta-analysis of real-world evidence

Abstract

Drug survival of biologics represents their real-world effectiveness and safety. We conducted a meta-analysis of real-world evidence on the drug survival of biologics in treating psoriasis. We searched the PubMed, CENTRAL, and EMBASE databases from inception to 7th October 2017 for studies reporting the annual drug survival for at least 1 year. Two authors independently screened and selected relevant studies, and assessed their risk of bias. A third author was available for arbitrating discrepancies. We conducted a random-effects model meta-analysis to obtain the respective pooled drug survival from year 1 to 4. We conducted subgroup analysis on biologic-naïve subjects, discontinuation for loss of efficacy and adverse effects. We included 37 studies with 32,631 subjects. The drug survival for all biologics decreased with time, dropping from 66% at year 1 to 41% at year 4 for etanercept, from 69% to 47% for adalimumab, from 61% to 42% for infliximab, and from 82% to 56% for ustekinumab. Ustekinumab was associated with the highest drug survival in all and biologic-naïve subjects. Etanercept was associated with the lowest drug survival and was most commonly discontinued for loss of efficacy. Infliximab was most frequently associated with discontinuation for adverse effects. Clinicians may use this study as a reference in treating psoriasis.

Targeted therapies for patients with moderate-to-severe psoriasis: a systematic review and network meta-analysis of PASI response at 1 year

“…In recent years, the number of treatments available for moderate-to-severe psoriasis has increased, enabling dermatologists to optimize therapy for patients to achieve better outcomes (8); however, choosing between therapies can be challenging. Numerous network meta-analyses (NMAs) that have investigated psoriasis therapies over the first 10 to 16 weeks of treatment have been published (9)(10)(11)(12)(13)(14) and yet only two reviews have quantitatively assessed the long-term efficacy of psoriasis therapies: one at 6 months (15) and another at 1 year (16). Since these studies were published, four new treatments have been licensed for psoriasiscertolizumab pegol, guselkumab, tildrakizumab, and risankizumab.…”

Epidemiology and Treatment of Patients with Rheumatoid Arthritis, Psoriatic Arthritis and Psoriasis in Germany: A Real-World Evidence Study

“…Real-world data are particularly useful to provide insights into the prevalence and treatment of diseases in heterogeneous patient populations beyond that obtained from randomised controlled trials [15,16]. At present, there are limited reports from real-world studies available for RA [17], PsA [3,18] and PSO [18][19][20][21][22]; in particular, real-world studies are scarce for the German population. This retrospective database study aimed to assess the epidemiology, comorbidities, diagnosis and treatment patterns of RA, PsA and PSO in the German population.…”

Long-Term Infliximab Treatment in Psoriasis Patients: A National Multicentre Retrospective Study

“…Although IFX is associated with weight gain in patients with psoriasis [5], our study cannot distinguish the effect of IFX on the weight regulation. It was previously reported that besides the type of biologic agent, the statistically significant predictors of drug persistence were a low BMI [5,7,8] and the association with PsA or inflammatory bowel diseases [4,7,9], whatever the drug used. In a previous study [10], we retrospectively analyzed factors associated with long-term drug survival of infliximab in psoriasis patients.…”

“…Although IFX has been available since 2005, there are very little data on the long-term drug survival of infliximab in real-life [2]. Most of drug survival studies for biologics in psoriasis are limited to 5 years [3][4][5].…”