Drug survival rates in patients with psoriasis after treatment with biologics

Umezawa, Yoshinori; Nobeyama, Yoshimasa; Hayashi, Morito; Fukuchi, Osamu; Ito, Toshihiro; Saeki, Hidehisa; Nakagawa, Hidemi

doi:10.1111/1346-8138.12353

Cited by 67 publications

(88 citation statements)

References 12 publications

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“…Thirteen observational studies with 17,444 patients reported on the comparative risk of discontinuation of TIMs due to AEs (see Supplementary Table 1, available Six observational studies reported only crude rates of discontinuation and did not provide comparative estimates (22)(23)(24)(25)(26)(27). These studies generally observed a higher proportion of patients discontinuing infliximab than adalimumab, etanercept, or anakinra treatment due to AEs in CD, RA, and plaque psoriasis.…”

Section: Resultsmentioning

confidence: 99%

Comparative Risk of Harm Associated With the Use of Targeted Immunomodulators: A Systematic Review

Desai

Thaler

Mahlknecht

et al. 2016

Arthritis Care & Research

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ObjectiveTo systematically compare the risk of adverse events (AEs) for 13 targeted immunomodulators (TIMs) indicated for ankylosing spondylitis (AS), inflammatory bowel diseases, juvenile idiopathic arthritis, plaque psoriasis, psoriatic arthritis (PsA), or rheumatoid arthritis (RA).MethodsWe searched electronic databases through July 2015 to retrieve randomized controlled trials (RCTs) and observational studies comparing AEs between 2 or more TIMs head‐to‐head. We reported on the following outcomes: number of AEs, discontinuation due to AEs, serious AEs, mortality, serious infections, tuberculosis, herpes zoster, and malignancies. We qualitatively synthesized the literature and conducted random‐effects meta‐analyses if 3 or more studies provided data for an outcome.ResultsTen head‐to‐head RCTs and 51 observational studies were included in this systematic review. A majority of the studies (70%) were conducted in RA patients. Risk of treatment discontinuation due to AEs was higher with infliximab than with adalimumab or etanercept in RA, PsA, and AS. A higher risk for serious infections was noted with infliximab than with abatacept, adalimumab, or etanercept in RA. Risk for treatment discontinuation due to AEs, serious infections, and tuberculosis was lower with etanercept than with adalimumab in RA. Limited evidence suggested no comparative differences in risk for mortality, malignancies, and herpes zoster for adalimumab, etanercept, and infliximab in RA.ConclusionImportant differences were noted in the safety profile of TIMs in RA, generally favoring abatacept, adalimumab, and etanercept over infliximab. Head‐to‐head comparative evidence for other TIMs and non‐RA populations was insufficient to draw conclusions for most of the safety outcomes.

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Section: Resultsmentioning

confidence: 99%

Comparative Risk of Harm Associated With the Use of Targeted Immunomodulators: A Systematic Review

Desai

Thaler

Mahlknecht

et al. 2016

Arthritis Care & Research

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“…Three of these studies have only reported on drug survival with TNFIs (Brunasso et al, 2012;Esposito et al, 2013;Gniadecki et al, 2011), while two involved the same Danish national psoriasis biologic safety registry data DERMBIO (Gniadecki et al, 2014;Gniadecki et al, 2011), with the other centres reporting data from either a single or a limited number of centres (Menting et al, 2014;Umezawa et al, 2013;van den Reek et al, 2014c). The…”

Section: Introductionmentioning

confidence: 99%

Differential Drug Survival of Biologic Therapies for the Treatment of Psoriasis: A Prospective Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR)

Warren

Smith

Yiu

et al. 2015

Journal of Investigative Dermatology

336

354

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Drug survival reflects a drug's effectiveness, safety, and tolerability. We assessed the drug survival of biologics used to treat psoriasis in a prospective national pharmacovigilance cohort (British Association of Dermatologists Biologic Interventions Register (BADBIR)). The survival rates of the first course of biologics for 3,523 biologic-naive patients with chronic plaque psoriasis were compared using survival analysis techniques and predictors of discontinuation analyzed using a multivariate Cox proportional hazards model. Data for patients on adalimumab (n=1,879), etanercept (n=1,098), infliximab (n=96), and ustekinumab (n=450) were available. The overall survival rate in the first year was 77%, falling to 53% in the third year. Multivariate analysis showed that female gender (hazard ratio (HR) 1.22; 95% confidence interval (CI): 1.09-1.37), being a current smoker (HR 1.19; 95% CI: 1.03-1.38), and a higher baseline dermatology life quality index (HR 1.01; 95% CI: 1.00-1.02) were predictors of discontinuation. Presence of psoriatic arthritis (HR 0.82; 95% CI: 0.71-0.96) was a predictor for drug survival. As compared with adalimumab, patients on etanercept (HR 1.63; 95% CI: 1.45-1.84) or infliximab (HR 1.56; 95% CI: 1.16-2.09) were more likely to discontinue therapy, whereas patients on ustekinumab were more likely to persist (HR 0.48; 95% CI: 0.37-0.62). After accounting for relevant covariates, ustekinumab had the highest first-course drug survival. The results of this study will aid clinical decision making when choosing biologic therapy for psoriasis patients.

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“…Clinical outcomes (mainly PASI) were reported in 75% of prospective studies [27, 39, 47-53], in about 50% of prospective registries [20, 24, 54-61] and retrospective studies [29, 30, 32, 34, 37, 62-70], and in no retrospective administrative databases/claims. Drug survival of biological therapies was reported in over 60% of prospective registries [14, 20, 21, 24, 25, 31, 54, 57, 71-74], retrospective studies [18, 19, 22, 23, 26, 29, 30, 32, 34, 37, 38, 68, 70, 75-77] and administrative databases/claims [28, 35, 36, 40-42, 46], and less frequently (33%) in prospective studies [27, 33, 52, 78]. Subanalyses on reasons of discontinuation, such as switching, dose augmentation, or biological therapy restarting, were scanty.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness End Points in Real-World Studies on Biological Therapies in Psoriasis: Systematic Review with Focus on Drug Survival

Costanzo¹,

Malara²,

Pelucchi³

et al. 2018

Dermatology

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Psoriasis is a complex and chronic disease, and, in most cases, therapies are required during all patients’ lifetime. The efficacy and safety profiles of biological therapies are well established, but their effectiveness is still open to discussion. We performed a systematic review to summarize how the effectiveness of biological therapies for psoriasis is measured in real-world studies and to understand whether drug survival, a recent alternative outcome to clinical ones, is a recurrent and valid outcome of effectiveness. In March 2017, we searched for quantitative epidemiological data of psoriasis treatments using PubMed/Medline and EMBASE, and we included 65 publications. The retrospective study design (37%) was most frequent, followed by prospective registries (29%), prospective studies (19%), and retrospective administrative databases/claims. Drug survival was reported in over 60% of prospective registries and retrospective studies, and less frequently in prospective studies. A general consensus emerged in the definition of drug survival as the time patients remain under treatment with a specific therapy, and in its interpretation as an overall marker of treatment success and treatment adherence, as it represents simultaneously information on drug efficacy, drug safety, and patient satisfaction. In conclusion, notwithstanding some limitations, drug survival is a useful measurement of biological therapy effectiveness for psoriasis in daily practice. Its major advantage is that it can be computed also in already collected databases without any specific clinical information on psoriasis. This outcome, combined with evidence on clinical markers of effectiveness, can contribute to better understanding the performance of this expensive class of drugs.

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Drug survival rates in patients with psoriasis after treatment with biologics

Cited by 67 publications

References 12 publications

Comparative Risk of Harm Associated With the Use of Targeted Immunomodulators: A Systematic Review

Comparative Risk of Harm Associated With the Use of Targeted Immunomodulators: A Systematic Review

Differential Drug Survival of Biologic Therapies for the Treatment of Psoriasis: A Prospective Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR)

Effectiveness End Points in Real-World Studies on Biological Therapies in Psoriasis: Systematic Review with Focus on Drug Survival

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