Drug survival of conventional systemic and biologic therapies for moderate-to-severe psoriasis in clinical practice in Spain: prospective results from the SAHARA study

Puig, L.; Carrascosa, José Manuel; Daudén, E.; Sulleiro, Sara; Guisado, Cristina

doi:10.1080/09546634.2019.1597244

Cited by 11 publications

(15 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, at 51%, the rate of discontinuation due to a lack of efficacy in the present study was significantly greater than that for other methotrexate drug survival studies, which ranged from 16% to 33% [10][11][12][16][17][18]29]. In contrast, the proportion of patients who stopped methotrexate therapy due to AEs was relatively consistent with previously reported data (present study: 34%; other studies: 12-47% [10][11][12][16][17][18]29]).…”

Section: Discussionsupporting

confidence: 88%

“…The median methotrexate drug survival in the present study thus lies on the low end of this spectrum, as half of the patients included had discontinued treatment after 11 months. However, differences in the studies performed make comparisons difficult to interpret, such as the inclusion of patients with different psoriasis types [10][11][12]15,26] versus plaque psoriasis only [14,16,18] and uncertainty for the combination therapy or concomitant folic acid [10][11][12][13][14][15][16]26]. For these aspects, the present cohort was similar to that of Otero and colleagues [16], where patients with plaque psoriasis were prescribed methotrexate monotherapy and folic acid supplementation.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have examined methotrexate drug survival in adult patients with psoriasis, with most comparing it to other conventional [10][11][12][13][14] or biological [10][11][12]14,15] agents. Four studies extensively focused on methotrexate [13,[16][17][18], three of which looked for predictors of drug survival [13,16,18].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Polymorphism in Gene for ABCC2 Transporter Predicts Methotrexate Drug Survival in Patients with Psoriasis

et al. 2021

View full text Add to dashboard Cite

Background and Objectives: Methotrexate is widely prescribed for the treatment of moderate-to-severe psoriasis. As drug survival encompasses efficacy, safety, and treatment satisfaction, such studies provide insights into successful drug treatments in the real-life scenario. The objective was to define methotrexate drug survival and reasons for discontinuation, along with factors associated with drug survival, in a cohort of adult patients with moderate-to-severe plaque psoriasis. Materials and Methods: Data on methotrexate treatment were extracted from our institutional registry. Drug survival was estimated by Kaplan–Meier analysis, and predictors of drug survival were analyzed by Cox proportional hazards regression. Results: We included 133 patients treated with methotrexate. Due to significant effects of the year of treatment initiation, drug survival analysis was performed for 117 patients who started methotrexate in 2010 or later. Median methotrexate drug survival was 11.0 months. Overall, 89% of patients discontinued treatment, with over half of these (51%) due to lack of efficacy. Significantly longer drug survival was seen for patients who discontinued treatment due to lack of efficacy versus drug safety (p = 0.049); when stratified by sex, this remained significant only for women (p = 0.002). The patient ABCC2 rs717620 genotype was significantly associated with drug survival in both univariate log-rank and multivariate Cox regression analyses, with variant T allele associated with longer drug survival (hazard ratio, 0.606; 95% confidence interval, 0.380–0.967; p = 0.036). Conclusions: We have identified the novel association of patient ABCC2 rs717620 genotype with methotrexate drug survival. This pharmacogenetic marker might thus help in the management of psoriasis patients in daily practice.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Polymorphism in Gene for ABCC2 Transporter Predicts Methotrexate Drug Survival in Patients with Psoriasis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Examining the main reasons for discontinuation is very important in drug survival research. Based on previous publications, the most common cause of discontinuation for biologic treatments was ineffectiveness, whereas it was adverse effects for conventional systemic treatments 8,23-26 . The study by Arnold et al 14 .…”

Section: Discussionmentioning

confidence: 99%

Drug survival and predictor factors for discontinuation of methotrexate in psoriasis: a real‐life multicenter study

et al. 2021

View full text Add to dashboard Cite

Background Drug survival is useful to evaluate long‐term drug performance in daily practice. The aim of this study was to evaluate drug survival for methotrexate (MTX) monotherapy in patients with plaque‐type psoriasis. Methods We reviewed 3,512 follow‐up charts of patients with psoriasis at five tertiary referral centers between January 2012 and January 2020. We analyzed baseline data and treatment outcomes of patients under MTX monotherapy. Drug survival was analyzed using Kaplan‐Meier and Cox regression analyses. Results Patients with psoriasis who were treated with MTX monotherapy were enrolled (N = 649). The median duration of drug survival was 15 months (95% CI: 13.2–16.8). The overall drug survival rate was 54.7%, 17.4%, and 8% after 1, 3, and 5 years, respectively. The main reasons for discontinuation were adverse effects (n = 209, 32.2%) and inefficacy (n = 105, 15.6%). Based on multivariate Cox regression analysis, the presence of nausea/vomiting (HR: 2.01, 95% CI: 1.49–2.71; P < 0.001) was observed as a statistically significant risk factor for drug discontinuation. Age over 50 years (HR: 0.68, 95% CI: 0.48–0.97; P = 0.03) and using MTX dose ≥15 mg/weekly were positive predictors for drug survival (HR: 0.72, 95% CI: 0.54–0.95; P = 0.02). Conclusions The average drug survival of MTX was 15 months. MTX is still the first‐line treatment of moderate‐to‐severe plaque psoriasis, as highlighted in guidelines. To prevent premature discontinuation, physicians need to look at the response time of at least 16–24 weeks, especially when a stepwise dose increment is used. The presence of nausea/vomiting seemed to be associated with an approximately twofold risk of discontinuation.

show abstract

“…It is known that drug survival decreases over time for all biologic therapies, mainly due to lack/ loss of efficacy, eventual remission and side effects, depending on the study. Drug survival of biologics, defined as the time from initiation to discontinuation of a particular treatment, is well documented in several registries and cohort studies [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Biologic Therapy for Moderate to Severe Psoriasis. Real-World Follow-up of Patients Who Initiated Biologic Therapy at Least 10 Years Ago

Elberdín

Fernández‐Torres

Paradela

et al. 2022

Dermatol Ther (Heidelb)

View full text Add to dashboard Cite

Introduction:The aim of this study was to evaluate response and drug survival of biologic therapy in patients with moderate to severe plaque-type psoriasis who initiated biologic therapy at least 10 years ago, in a real-world setting. Methods: This was an observational retrospective follow-up study that included patients with moderate to severe plaque-type psoriasis who initiated biologic therapy between October 2006 and December 2009. Efficacy was expressed as the percentage of patients achieving a 50, 75 and 90% reduction from baseline in the Psoriasis Area and Severity Index (PASI 50, PASI 75, PASI 90, respectively) every 3 months during the first year of therapy and then every 12 months up to the end of follow-up or withdrawal from the study. Results: A total of 56 patients were included in the study, representing 140 treatment lines (median 2, range 1-8); of these patients, 53 were still receiving biologic therapy at the end of the study. The mean duration of biologic therapy was 140.4 (range 47.6-175.4) months. Etanercept was used in 98.2% of patients, followed by efalizumab (42.9%), adalimumab (41.1%), ustekinumab (33.9%) and infliximab (16.1%). Treatment lines were switched in 62.1% of treatments: 24.3% due to secondary failure, 20.7% due to primary failure and 3.6% due to side effects. No patient treated with anti-interleukins had to discontinue treatment due to side effects. Ustekinumab had the highest drug survival.Conclusions: This study in the real-world-setting shows maintenance of long-term efficacy and safety of biologic therapy in patients with moderate to severe plaque psoriasis in daily practice who initiated biologic therapy 10 years ago.

show abstract

Drug survival of conventional systemic and biologic therapies for moderate-to-severe psoriasis in clinical practice in Spain: prospective results from the SAHARA study

Cited by 11 publications

References 28 publications

Polymorphism in Gene for ABCC2 Transporter Predicts Methotrexate Drug Survival in Patients with Psoriasis

Polymorphism in Gene for ABCC2 Transporter Predicts Methotrexate Drug Survival in Patients with Psoriasis

Drug survival and predictor factors for discontinuation of methotrexate in psoriasis: a real‐life multicenter study

Biologic Therapy for Moderate to Severe Psoriasis. Real-World Follow-up of Patients Who Initiated Biologic Therapy at Least 10 Years Ago

Contact Info

Product

Resources

About