Patient-reported reasons for the discontinuation of commonly used treatments for moderate to severe psoriasis

Yeung, Howa; Wan, Joy; Voorhees, Abby S. Van; Duffin, Kristina Callis; Krueger, Gerald G.; Kalb, Robert E.; Weisman, Jamie; Sperber, Brian R.; Brod, Bruce A.; Schleicher, Stephen M.; Bebo, Bruce F.; Shin, Daniel B.; Troxel, Andrea B.; Gelfand, Joel M.

doi:10.1016/j.jaad.2012.06.035

Cited by 107 publications

(105 citation statements)

References 37 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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“…Classic approaches provided varying degrees of efficacy in the management of psoriasis. The most effective therapies are characterized by underutilization, inconvenience and adverse events, making long-term management challenging [25]. The efficacy of ustekinumab in psoriasis has been demonstrated by the PHOENIX 1 study, which shows a significantly higher proportion of patients reaching the primary and secondary endpoints compared to placebo [12].…”

Section: Discussionmentioning

confidence: 99%

What Happened after the Clinical Trials: Long-Term Safety and Efficacy of Ustekinumab in Daily Clinical Practice

Talamonti

Galluzzo²,

Bianchi³

et al. 2014

Dermatology

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Background: Ustekinumab has been investigated in patients with psoriasis by randomized clinical trials. There are few data on ustekinumab use under ‘real life' conditions outside long-term registries. Objective: The aim of our study was to evaluate the efficacy and safety of ustekinumab as a long-term therapy in real life. Methods: We retrospectively analyzed the data of 71 patients who had been treated with ustekinumab up to 2 years. Efficacy data were analyzed both by ‘as treated' and ‘intention to treat-last observation carried forward'. Results: A significant improvement in the Psoriasis Area and Severity Index score was observed at 4 weeks and further improvements were observed throughout the treatment. Adverse events were generally mild. Conclusions: In routine administration ustekinumab seems to be more efficient than reported by randomized clinical trials. Our results are encouraging and can answer the patients' biggest concern on whether ustekinumab is an effective and safe drug for long-term use.

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“…Allerdings stellt sich gleichzeitig die Frage, bei wie vielen Patienten es zu einem Behandlungsabbruch im ersten Jahr der Behandlung kommt, so dass etwa 50% der Psoriasis-Patienten die Behandlung nicht länger als 3 Jahre durchführen. Die durchschnittliche Anzahl der Monate mit Behandlung wird mit einem Wert zwischen 20 und 25 angegeben [4,9,11]. Der Einfluss einer Depression zu Beginn der Therapie ist bisher fast noch nie untersucht worden [3].…”

Section: Transfer In Die Praxis Von Prof Dr Uwe Gieler (Gießen)unclassified

Depressive Psoriasis-Patienten können ein schlechteres Ansprechen auf Etanercept zeigen - eine weitere Expertenmeinung

Gieler¹

2019

Kompass Dermatol

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Background/Aims: This study aimed to investigate the predicting values of depression and anxiety symptoms for clinical response to etanercept treatment in psoriasis patients. Methods: A total of 85 psoriasis patients who received 6 months of etanercept treatment were consecutively enrolled in this prospective cohort study. The Psoriasis Area and Severity Index (PASI) score was evaluated at month 0 (M0), M1, M3, and M6, and the corresponding PASI 75/90 response at each visit was assessed. Also, anxiety and depression symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS) at M0, M1, M3, and M6. Results: Depression symptoms were observed to correlate with female gender (p = 0.004), longer disease duration (p = 0.018), and higher PASI score (p < 0.001), and anxiety symptoms were seen to be associated with female gender (p = 0.017), larger psoriasis-affected body surface area (p = 0.049), and higher PASI score (p = 0.017) in psoriasis patients. After etanercept treatment, HADS-Depression (HADS-D) and HADSAnxiety (HADS-A) scores were both decreased at M1, M3, and M6 (all p < 0.001) compared with M0. Most importantly, baseline depressed patients presented with a lower PASI 75 response rate at M3 (p = 0.014) and M6 (p = 0.005), and a reduced PASI 90 response rate at M6 (p = 0.045) compared with baseline non-depressed patients. Furthermore, multivariate logistic regression analyses revealed that depression symptoms at baseline were an independent predictive factor for the lower possibility of both PASI 75 response (p = 0.048) and PASI 90 response (p = 0.048) achievements at M6 in psoriasis patients. However, no correlation of baseline anxiety symptoms with PASI 75/90 responses was observed. Conclusion: Depression symptoms at baseline independently predict a worse clinical response to etanercept treatment in psoriasis patients.

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Patient-reported reasons for the discontinuation of commonly used treatments for moderate to severe psoriasis

Cited by 107 publications

References 37 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

What Happened after the Clinical Trials: Long-Term Safety and Efficacy of Ustekinumab in Daily Clinical Practice

Depressive Psoriasis-Patienten können ein schlechteres Ansprechen auf Etanercept zeigen - eine weitere Expertenmeinung

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