Patient Adherence to Biologic Agents in Psoriasis

Hsu, Der Yi; Gniadecki, Robert

doi:10.1159/000444581

Cited by 25 publications

(19 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We have shown that when compared with adalimumab, taking etanercept was a predictor for discontinuation overall and because of ineffectiveness, whereas taking ustekinumab was a predictor of drug survival. Possible reasons contributing to the observed higher drug survival with second-line use of ustekinumab could include differences in clinical effectiveness ( Griffiths et al., 2010 , Reich et al., 2012 ), speed of onset of action ( Nast et al., 2013 ), low immunogenicity ( Carrascosa et al., 2014 ), and nurse-administered injections provided every 12-weeks, compared with the more frequent self-injection regimens for other biologic therapies, which may contribute to improved drug adherence and treatment satisfaction ( Goren et al., 2016 , Hsu and Gniadecki, 2016 , Schaarschmidt et al., 2015 ).…”

Section: Discussionmentioning

confidence: 99%

Differential Drug Survival of Second-Line Biologic Therapies in Patients with Psoriasis: Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR)

Iskandar

Warren

Lunt

et al. 2018

Journal of Investigative Dermatology

View full text Add to dashboard Cite

Little is known about the drug survival of second-line biologic therapies for psoriasis in routine clinical practice. We assessed drug survival of second-line biologic therapies and estimated the risk of recurrent discontinuation due to adverse events or ineffectiveness in patients with psoriasis who had failed a first biologic therapy and switched to a second in a large, multicenter pharmacovigilance registry (n = 1,239; adalimumab, n = 538; etanercept, n = 104; ustekinumab, n = 597). The overall drug survival rate in the first year after switching was 77% (95% confidence interval = 74–79%), falling to 58% (55–61%) in the third year. Female sex, multiple comorbidities, concomitant therapy with cyclosporine, and a high Psoriasis Area and Severity Index at switching to the second-line biologic therapy were predictors of overall discontinuation (multivariable Cox proportional hazard model). Compared to adalimumab, patients receiving etanercept were more likely to discontinue therapy (hazard ratio = 1.87, 95% confidence interval = 1.24–2.83), whereas patients receiving ustekinumab were more likely to persist (hazard ratio = 0.46; 95% confidence interval = 0.33–0.64). Discontinuation of the first biologic therapy because of adverse events was associated with an increased rate of second drug discontinuation because of adverse events (hazard ratio = 2.55; 95% confidence interval = 1.50–4.32). In conclusion, drug survival rates differed among biologic therapies and decreased over time; second-line discontinuation because of adverse events was more common among those who discontinued first-line treatment for this reason. The results of this study should support clinical decision making when choosing second-line biologic therapy for patients with psoriasis.

show abstract

Section: Discussionmentioning

confidence: 99%

Differential Drug Survival of Second-Line Biologic Therapies in Patients with Psoriasis: Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR)

Iskandar

Warren

Lunt

et al. 2018

Journal of Investigative Dermatology

View full text Add to dashboard Cite

show abstract

“…34 In patients with acne, the adherence to oral retinoids was 57%, whereas to topical retinoids only 2%. 54 Biologic agents have shown relatively good adherence rates, ranging from 58% to 100%, 52,[58][59][60] which is higher than the adherence rates reported for oral therapy. 61 In two trials including only psoriasis patients, ustekinumab showed the best overall adherence rate among systemic therapies studied (acitretin, methotrexate, adalimumab, etanercept, infliximab).…”

Section: Treatment-relatedmentioning

confidence: 90%

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

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.

show abstract

“…The percentage of patients who discontinued biological therapies within the end of the follow-up period was reported in 90% of retrospective administrative databases/claims [28, 35, 36, 40-45] and in about 60% of other study designs. Compliance with biological therapies was rarely considered in these effectiveness studies [15, 43, 45, 53]. …”

Section: Resultsmentioning

confidence: 99%

“…This conclusion was based on improvement of the clinical outcome Psoriasis Area and Severity Index (PASI) response only. However, considering only a clinical outcome to measure the effectiveness of biological therapies in daily practice may not reflect the patients’ perception of treatment success [15, 16]. Recently, several articles proposed an alternative outcome for evaluating the effectiveness of biological therapies, called drug survival (or different synonyms, such as drug persistence) [16].…”

Section: Introductionmentioning

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

View full text Add to dashboard Cite

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.

show abstract

Patient Adherence to Biologic Agents in Psoriasis

Cited by 25 publications

References 24 publications

Differential Drug Survival of Second-Line Biologic Therapies in Patients with Psoriasis: Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR)

Differential Drug Survival of Second-Line Biologic Therapies in Patients with Psoriasis: Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR)

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

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

Contact Info

Product

Resources

About