TY - JOUR
T1 - Biologic drug survival rates in the era of anti-interleukin-17 antibodies
T2 - a time-period-adjusted registry analysis
AU - Graier, T
AU - Salmhofer, W
AU - Jonak, C
AU - Weger, W
AU - Kölli, C
AU - Gruber, B
AU - Sator, P G
AU - Prillinger, K
AU - Mlynek, A
AU - Schütz-Bergmayr, M
AU - Richter, L
AU - Ratzinger, G
AU - Painsi, C
AU - Selhofer, S
AU - Häring, N
AU - Wippel-Slupetzky, K
AU - Skvara, H
AU - Trattner, H
AU - Tanew, A
AU - Inzinger, M
AU - Tatarski, R
AU - Bangert, C
AU - Ellersdorfer, C
AU - Lichem, R
AU - Gruber-Wackernagel, A
AU - Hofer, A
AU - Legat, F
AU - Schmiedberger, E
AU - Strohal, R
AU - Lange-Asschenfeldt, B
AU - Schmuth, M
AU - Vujic, I
AU - Hoetzenecker, W
AU - Trautinger, F
AU - Saxinger, W
AU - Müllegger, R
AU - Quehenberger, F
AU - Wolf, P
N1 - Funding Information:
sources The Austrian Psoriasis Registry (PsoRA) was supported by unrestricted research grants or educational grants from the following pharmaceutical companies: AbbVie (2015–2019), Almirall (2017–2020), Amgen GmbH (2019–2020), Celgene (2016–2018), Eli Lilly (2015–2020), Janssen (2014–2016), Leo Pharma (2014–2020), Merck Sharp & Dohme (2014), Novartis (2019), Pfizer (2008–2018) and Sandoz (2020). The study was also supported by the Austrian Society for Dermatology and Venereology.We thank the patients participating in PsoRA and all members of PsoRA (see https://psora.medunigraz.at/) who provided data for this analysis. Special thanks go to Matthias Wagner, Vienna, for development of the original electronic PsoRA database; Maximilian Errath for technical support; and Andrea Berghold, Department Chair, Institute for Medical Informatics, Statistics and Documentation for continuous support in further development of the PsoRA database. We also thank Martina Praszl-Posch and Kirsten Sommer for support of data entry into the PsoRA database, Honnavara N. Ananthaswamy, Houston, TX, for critical reading of the manuscript, and Jude Richard, Austin, TX, for editing of the manuscript. This work has been conducted as part of a doctoral thesis (T.G.).
Publisher Copyright:
© 2021 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists
PY - 2021/6
Y1 - 2021/6
N2 - 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.
AB - 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.
KW - Adalimumab
KW - Austria
KW - Biological Products
KW - Cohort Studies
KW - Etanercept
KW - Female
KW - Humans
KW - Psoriasis/drug therapy
KW - Registries
KW - Retrospective Studies
KW - Survival Rate
KW - Treatment Outcome
KW - Ustekinumab
UR - http://www.scopus.com/inward/record.url?scp=85101204377&partnerID=8YFLogxK
U2 - 10.1111/bjd.19701
DO - 10.1111/bjd.19701
M3 - Journal article
C2 - 33289075
SN - 0007-0963
VL - 184
SP - 1094
EP - 1105
JO - British Journal of Dermatology
JF - British Journal of Dermatology
IS - 6
ER -