Real‐world comparative effectiveness of adalimumab, etanercept and methotrexate: a Swedish register analysis

Svedbom, Axel; Ståhle, Mona

doi:10.1111/jdv.15978

Cited by 14 publications

(15 citation statements)

References 41 publications

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“…Compared with our findings, a recent Swedish registry study observed a similar median drug survival rate for adalimumab but a worse median discontinuation rate for etanercept (17Á5 months vs. 27Á0 months). 37 A recent analysis of a smaller dataset from the Slovenian psoriasis registry (with regard to IL-17 inhibitors) also found a similar drug survival rate for ustekinumab but lower rates for ixekizumab and secukinumab. 38 Likewise, a recent Italian study found a relatively high survival rate of ustekinumab, 39 similar to the rate for secukinumab, but much higher than the rates for adalimumab, infliximab and etanercept (ixekizumab was not included in the study).…”

Section: Discussionmentioning

confidence: 93%

Biologic drug survival rates in the era of anti‐interleukin‐17 antibodies: a time‐period‐adjusted registry analysis*

et al. 2021

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Summary Background Drug survival rates reflect efficacy and safety and may be influenced by the availability of alternative treatment options. Little is known about time‐dependent drug survival in psoriasis and the effect of increasing numbers of biologic treatment options. Objectives To determine whether drug survival is influenced by the availability of treatment options and by factors such as gender, psoriatic arthritis or previous biologic treatment. Methods This observational, retrospective, multicentre cohort study analysed data from patients registered in the Austrian Psoriasis Registry (PsoRA) who were treated with biologics between 1 January 2015 and 30 November 2019. Results A total of 1572 patients who received 1848 treatment cycles were included in this analysis. The highest long‐term Psoriasis Area and Severity Index improvement was observed after treatment with ixekizumab, followed by ustekinumab and secukinumab, adalimumab and etanercept. Overall, ustekinumab surpassed all other biologics in drug survival up to 48 months. However, when adjusted for biologic naïvety, its superiority vanished and drug survival rates were similar for ixekizumab (91·6%), secukinumab (90·2%) and ustekinumab (92·8%), all of them superior to adalimumab (76·5%) and etanercept (71·9%) at 12 months and beyond. Besides biologic non‐naïvety (2·10, P < 0·001), the introduction of a new drug such as secukinumab or ixekizumab (relative hazard ratio 1·6, P = 0·001) and female gender (1·50, P = 0·019) increased the risk of treatment discontinuation overall, whereas psoriatic arthritis did not (1·12, P = 0·21). Conclusions The time‐dependent availability of drugs should be considered when analysing and comparing drug survival. Previous biologic exposure significantly influences drug survival. Women are more likely to stop treatment.

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Section: Discussionmentioning

confidence: 93%

Biologic drug survival rates in the era of anti‐interleukin‐17 antibodies: a time‐period‐adjusted registry analysis*

et al. 2021

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“…For instance, in psoriasis patients some studies reported more adverse events in female patients [80,81] whereas other studies did not find this association [82]. Similarly, the retention rates of biologicals in psoriasis patients were found to be associated with female sex in some studies [83,84] but not in others [85,86]. The same holds true in rheumatology patients treated with biologicals.…”

Section: Discussionmentioning

confidence: 97%

Patient sex does not affect endoscopic outcomes of biologicals in inflammatory bowel disease but is associated with adverse events

Lie

Paulides

Woude

2020

Int J Colorectal Dis

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Purpose Biological therapies are currently the mainstay in the treatment of patients with inflammatory bowel diseases (IBD). Several factors are known to influence the efficacy and tolerability of biologicals, such as CRP levels or previous biological use. Whether patient sex affects the efficacy or tolerability is unclear but would help with better risk and benefit stratification. This systematic review assesses patient sex on the efficacy and tolerability of biological therapies in IBD patients. Methods A systematic literature review was performed using Embase (including MEDLINE), MEDLINE OvidSP, Cochrane Central Register of Controlled Trials, Web of Science and PubMed. The primary outcome was the influence of patient sex on endoscopic outcomes in IBD patients treated with biologicals. The secondary outcome was the influence of patient sex on adverse events. Studies were included in the assessment regardless of study type or setting. Results The search yielded 19,461 citations; after review, 55 studies were included in the study, involving 28,465 patients treated with adalimumab, certolizumab pegol, infliximab, or vedolizumab. There was no significant association between patient sex and endoscopic efficacy in 41 relevant studies. Increased adverse events were associated with female sex in 7 out of 14 relevant studies. Conclusions There is no evidence for a sex difference in endoscopically measured response to biological therapies in IBD patients. However, there is an influence of sex on the occurrence of adverse events.

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“…Almost the same proportion of patients discontinued treatment in this group, with a similar median methotrexate drug survival of 11.0 months. Other studies that have investigated methotrexate drug survival in adult patients with psoriasis have reported median drug survivals of 9.15 months [26], 12.1 months [11], 15 months [18], 18 months [13], 21.6 months [16], and 29.3 months [15]. Additionally, mean drug survivals have been reported as 7.7 months [14], 17.2 months [27], 18.8 months [17], and 22.3 months [10].…”

Section: Discussionmentioning

confidence: 99%

“…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%

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

et al. 2021

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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.

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Real‐world comparative effectiveness of adalimumab, etanercept and methotrexate: a Swedish register analysis

Cited by 14 publications

References 41 publications

Biologic drug survival rates in the era of anti‐interleukin‐17 antibodies: a time‐period‐adjusted registry analysis*

Biologic drug survival rates in the era of anti‐interleukin‐17 antibodies: a time‐period‐adjusted registry analysis*

Patient sex does not affect endoscopic outcomes of biologicals in inflammatory bowel disease but is associated with adverse events

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

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