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Drug Survival of IL-12/23, IL-17 and IL-23 Inhibitors for Psoriasis Treatment: A Retrospective Multi-Country, Multicentric Cohort Study
T. Torres, L. Puig, R. Vender, C. Lynde, S. Piaserico, JM. Carrascosa, P. Gisondi, E. Daudén, C. Conrad, P. Mendes-Bastos, P. Ferreira, L. Leite, JD. Lu, J. Valerio, M. Bruni, F. Messina, A. Nidegger, M. Llamas-Velasco, E. Del Alcazar, A. Mufti,...
Jazyk angličtina Země Nový Zéland
Typ dokumentu srovnávací studie, časopisecké články, multicentrická studie
NLK
ProQuest Central
od 2008-05-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 2008-05-01 do Před 1 rokem
- MeSH
- biologické přípravky farmakologie terapeutické užití MeSH
- časové faktory MeSH
- dermatologické látky farmakologie terapeutické užití MeSH
- dospělí MeSH
- indukce remise metody MeSH
- interleukin-12 antagonisté a inhibitory imunologie MeSH
- interleukin-17 antagonisté a inhibitory imunologie MeSH
- interleukin-23 antagonisté a inhibitory imunologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- psoriáza farmakoterapie imunologie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- srovnávací studie MeSH
BACKGROUND: Drug survival analysis of biologic agents in psoriasis is of extreme importance, as it allows not only the evaluation of objective clinical outcomes (such as effectiveness and safety) but also of factors that are associated with patients' adherence to treatment. The aim of this study was to evaluate and compare the drug survival of the most recent biologic agents approved for the treatment of moderate-to-severe psoriasis-ustekinumab, secukinumab, ixekizumab, brodalumab, guselkumab, and risankizumab-and to identify clinical predictors that can influence the drug survival of these drugs. METHODS: This retrospective multicentric cohort study from 16 dermatology centers in Portugal, Spain, Italy, Switzerland, Czech Republic, Canada, and the United States included patients that started IL-12/23, IL-17 (IL-17A and IL-17R) and IL-23 inhibitors for the treatment of psoriasis between January 1, 2012 and December 31, 2019. Survival analysis was performed using a Kaplan-Meier estimator, to obtain descriptive survival curves, and proportional hazard Cox regression models. RESULTS: A total of 3312 treatment courses (total patients: 3145) were included in the study; 1118 (33.8%) with an IL-12/23 inhibitor (ustekinumab), 1678 (50.7%) with an IL-17 inhibitor [911 (27.5%) on secukinumab, 651 (19.7%) on ixekizumab, 116 (3.5%) on brodalumab], and 516 (15.5%) with an IL-23 inhibitor [398 (12.0%) on guselkumab, 118 (3.5%) on risankizumab]. At 18 months, the cumulative probability of survival was 96.4% for risankizumab, 91.1% for guselkumab, 86.3% for brodalumab, 86.1% for ustekinumab, 82.0% for ixekizumab, and 79.9% for secukinumab. Using ustekinumab as reference, drug survival of guselkumab was higher (HR 0.609; 95% CI 0.418-0.887) and that of secukinumab was lower (HR 1.490; 95% CI 1.257-1.766). In the final multivariable model, secukinumab, female sex, higher BMI, and prior exposure to biologic agents significantly increased the risk of drug discontinuation, whereas risankizumab was protective. CONCLUSION: In this multinational cohort with 8439 patient-years of follow-up, the cumulative probability of drug survival for all drugs was >79% at 18 months. Prescribed biologic, female sex, higher BMI, and previous exposure to biologic agents were predictors of drug discontinuation. Drug survival of guselkumab and risankizumab was higher than that of ustekinumab, and secukinumab was lower.
Center for Health Technology and Services Research Porto Portugal
Clínica Médica Belém Lisbon Portugal
Department of Dermatology Centro Hospitalar Universitário do Porto Porto Portugal
Department of Dermatology Germans Trias i Pujol University Hospital Badalona Spain
Department of Dermatology Hospital de la Santa Creu i Sant Pau Barcelona Spain
Department of Dermatology University of Pisa Pisa Italy
Dermatology Unit Department of Medicine University of Padua 35128 Padua Italy
Fondazione Policlinico Universitario A Gemelli IRCCS Rome Italy
Hospital CUF Descobertas Lisbon Portugal
Instituto de Ciências Biomédicas Abel Salazar University of Porto Porto Portugal
Lynde Institute for Dermatology Markham Ontario Canada
McMaster University Hamilton Ontario Canada
Michael G DeGroote School of Medicine Faculty of Medicine Hamilton Ontario Canada
Università Cattolica del Sacro Cuore Largo Agostino Gemelli 8 00168 Rome Italy
Citace poskytuje Crossref.org
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- $a BACKGROUND: Drug survival analysis of biologic agents in psoriasis is of extreme importance, as it allows not only the evaluation of objective clinical outcomes (such as effectiveness and safety) but also of factors that are associated with patients' adherence to treatment. The aim of this study was to evaluate and compare the drug survival of the most recent biologic agents approved for the treatment of moderate-to-severe psoriasis-ustekinumab, secukinumab, ixekizumab, brodalumab, guselkumab, and risankizumab-and to identify clinical predictors that can influence the drug survival of these drugs. METHODS: This retrospective multicentric cohort study from 16 dermatology centers in Portugal, Spain, Italy, Switzerland, Czech Republic, Canada, and the United States included patients that started IL-12/23, IL-17 (IL-17A and IL-17R) and IL-23 inhibitors for the treatment of psoriasis between January 1, 2012 and December 31, 2019. Survival analysis was performed using a Kaplan-Meier estimator, to obtain descriptive survival curves, and proportional hazard Cox regression models. RESULTS: A total of 3312 treatment courses (total patients: 3145) were included in the study; 1118 (33.8%) with an IL-12/23 inhibitor (ustekinumab), 1678 (50.7%) with an IL-17 inhibitor [911 (27.5%) on secukinumab, 651 (19.7%) on ixekizumab, 116 (3.5%) on brodalumab], and 516 (15.5%) with an IL-23 inhibitor [398 (12.0%) on guselkumab, 118 (3.5%) on risankizumab]. At 18 months, the cumulative probability of survival was 96.4% for risankizumab, 91.1% for guselkumab, 86.3% for brodalumab, 86.1% for ustekinumab, 82.0% for ixekizumab, and 79.9% for secukinumab. Using ustekinumab as reference, drug survival of guselkumab was higher (HR 0.609; 95% CI 0.418-0.887) and that of secukinumab was lower (HR 1.490; 95% CI 1.257-1.766). In the final multivariable model, secukinumab, female sex, higher BMI, and prior exposure to biologic agents significantly increased the risk of drug discontinuation, whereas risankizumab was protective. CONCLUSION: In this multinational cohort with 8439 patient-years of follow-up, the cumulative probability of drug survival for all drugs was >79% at 18 months. Prescribed biologic, female sex, higher BMI, and previous exposure to biologic agents were predictors of drug discontinuation. Drug survival of guselkumab and risankizumab was higher than that of ustekinumab, and secukinumab was lower.
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