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Ting S, Lowe P, Smith A, Fernández-Peñas P. Drug survival of biologics in psoriasis: An Australian multicentre retrospective study. Australas J Dermatol 2024; 65:350-357. [PMID: 38509804 DOI: 10.1111/ajd.14254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 02/08/2024] [Accepted: 03/11/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Drug survival, which refers to the time from treatment initiation to discontinuation, provides a surrogate measure of the effectiveness of a biologic in a real-world setting (J Invest Dermatol, 2015, 135, 1). The aim of this study was to determine the drug survival of biologics that are currently available in Australia. We also analysed the treatment efficacy of these biologics and reasons for discontinuation. METHODS Retrospective data from outpatient Dermatology biologic clinics in Westmead Hospital and Royal Prince Alfred Hospital (Sydney, Australia) from April 2006 to December 2020 were collected. Kaplan-Meier analysis was used to calculate drug survival. RESULTS A total of 306 patients who underwent 566 treatment courses were analysed. Guselkumab was observed to have the longest drug survival, with cumulative drug survival rates of 94.2% ± 4.0 at 1- and 5-years. This was followed by ixekizumab which had a 1-year survival rate of 87.2% ± 4.5 and 5-year survival rate of 59.4% ± 9.5. Ixekizumab and guselkumab were also noted to have superior treatment efficacy compared with other biologics, with PASI-75 rates of 94.9% and 93.8%, respectively. The most common reasons for treatment discontinuation were a lack of initial efficacy to treatment and a loss of efficacy over time despite an initial response, respectively. CONCLUSION To our knowledge, this is the first Australian study to report on outcomes of multiple new biologics that are currently in use for the treatment of chronic plaque psoriasis. Overall, this study provides insight into patterns of care from a local experience that may help guide the management of moderate-to-severe psoriasis.
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Affiliation(s)
- Samantha Ting
- The University of Sydney, Camperdown, New South Wales, Australia
| | - Patricia Lowe
- The University of Sydney, Camperdown, New South Wales, Australia
- Department of Dermatology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Annika Smith
- The University of Sydney, Camperdown, New South Wales, Australia
- Department of Dermatology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Pablo Fernández-Peñas
- The University of Sydney, Camperdown, New South Wales, Australia
- Department of Dermatology, Westmead Hospital, Sydney, New South Wales, Australia
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2
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Roy T, Banang-Mbeumi S, Boateng ST, Ruiz EM, Chamcheu RCN, Kang L, King JA, Walker AL, Nagalo BM, Kousoulas KG, Esnault S, Huang S, Chamcheu JC. Dual targeting of mTOR/IL-17A and autophagy by fisetin alleviates psoriasis-like skin inflammation. Front Immunol 2023; 13:1075804. [PMID: 36741386 PMCID: PMC9889994 DOI: 10.3389/fimmu.2022.1075804] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/28/2022] [Indexed: 01/19/2023] Open
Abstract
Psoriasis is a chronic autoimmune inflammatory skin disorder characterized by epidermal hyperplasia and aberrant immune response. In addition to aberrant cytokine production, psoriasis is associated with activation of the Akt/mTOR pathway. mTOR/S6K1 regulates T-lymphocyte activation and migration, keratinocytes proliferation and is upregulated in psoriatic lesions. Several drugs that target Th1/Th17 cytokines or their receptors have been approved for treating psoriasis in humans with variable results necessitating improved therapies. Fisetin, a natural dietary polyphenol with anti-oxidant and anti-proliferative properties, covalently binds mTOR/S6K1. The effects of fisetin on psoriasis and its underlying mechanisms have not been clearly defined. Here, we evaluated the immunomodulatory effects of fisetin on Th1/Th17-cytokine-activated adult human epidermal keratinocytes (HEKa) and anti-CD3/CD28-stimulated inflammatory CD4+ T cells and compared these activities with those of rapamycin (an mTOR inhibitor). Transcriptomic analysis of HEKa revealed 12,713 differentially expressed genes (DEGs) in the fisetin-treated group compared to 7,374 DEGs in the rapamycin-treated group, both individually compared to a cytokine treated group. Gene ontology analysis revealed enriched functional groups related to PI3K/Akt/mTOR signaling pathways, psoriasis, and epidermal development. Using in silico molecular modeling, we observed a high binding affinity of fisetin to IL-17A. In vitro, fisetin significantly inhibited mTOR activity, increased the expression of autophagy markers LC3A/B and Atg5 in HEKa cells and suppressed the secretion of IL-17A by activated CD4+ T lymphocytes or T lymphocytes co-cultured with HEKa. Topical administration of fisetin in an imiquimod (IMQ)-induced mouse psoriasis model exhibited a better effect than rapamycin in reducing psoriasis-like inflammation and Akt/mTOR phosphorylation and promoting keratinocyte differentiation and autophagy in mice skin lesions. Fisetin also significantly inhibited T-lymphocytes and F4/80+ macrophage infiltration into skin. We conclude that fisetin potently inhibits IL-17A and the Akt/mTOR pathway and promotes keratinocyte differentiation and autophagy to alleviate IMQ-induced psoriasis-like disease in mice. Altogether, our findings suggest fisetin as a potential treatment for psoriasis and possibly other inflammatory skin diseases.
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Affiliation(s)
- Tithi Roy
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA, United States
| | - Sergette Banang-Mbeumi
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA, United States
- School of Nursing and Allied Health Sciences, Louisiana Delta Community College, Monroe, LA, United States
| | - Samuel T. Boateng
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA, United States
| | - Emmanuelle M. Ruiz
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, United States
| | - Roxane-Cherille N. Chamcheu
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA, United States
| | - Lin Kang
- Biomedical Research, Edward Via College of Osteopathic Medicine, Monroe, LA, United States
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, United States
| | - Judy A. King
- Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center, Shreveport, LA, United States
| | - Anthony L. Walker
- School of Clinical Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA, United States
| | - Bolni Marius Nagalo
- Department of Pathology, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, United States
- The Winthrop P. Rockefeller Cancer Institute, UAMS, Little Rock, AR, United States
| | - Konstantin G. Kousoulas
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, United States
| | - Stephane Esnault
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine and Public Health, Madison, WI, United States
| | - Shile Huang
- Department of Biochemistry and Molecular Biology, Louisiana State University Health Sciences Center, Shreveport, LA, United States
- Department of Hematology and Oncology, Louisiana State University Health Sciences Center, Shreveport, LA, United States
- Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA, United States
| | - Jean Christopher Chamcheu
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA, United States
- Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center, Shreveport, LA, United States
- Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA, United States
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Dodero-Anillo JM, Lozano-Cuadra IC, Rios-Sanchez E, Pedrosa-Martinez MJ, Ruiz-Carrascosa JC, Galan-Gutierrez M, Armario-Hita JC. Optimising the Therapeutic Interval for Biologics in Patients with Psoriasis. Life (Basel) 2022; 12:2075. [PMID: 36556440 PMCID: PMC9787329 DOI: 10.3390/life12122075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/25/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
In our clinical experience, more than half of patients do not present a complete response to biologic drugs, or drug loses its efficacy over time. Plasma determinations of drug and anti-drug antibodies levels are an objective tool for optimisation in these patients; however, established therapeutic ranges are not suitable, so the objective of this study was to study these patients and optimise their healthcare. We have made a retrospective, observational study, using data of plasma levels of drugs and anti-drugs antibodies of infliximab, adalimumab or Etanercept, we summarise all data and make a study of sensitivity, specificity, positive and negative predictive value on current therapeutic ranges. We have found a statistically significant association between subtherapeutic levels and therapeutic failure in psoriasis treated with infliximab and adalimumab. New ranges were found with higher sensitivity than the established ones, we propose 2-10 µg/mL therapeutic range for infliximab, 3-11 µg/mL for adalimumab, and 1-7 µg/mL for etanercept. In conclusion, levels of drug and anti-drug antibodies are a decisive tool for predicting therapeutic response. The current therapeutic ranges may have minimum values that are excessively high, owing to which lowering them significantly increases the sensitivity of the test in all cases, and negative predictive value in the case of etanercept. Further prospective studies are needed to prove the usefulness of these new ranges.
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Adherence and Persistence to Biological Drugs for Psoriasis: Systematic Review with Meta-Analysis. J Clin Med 2022; 11:jcm11061506. [PMID: 35329831 PMCID: PMC8953825 DOI: 10.3390/jcm11061506] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 02/07/2023] Open
Abstract
Despite the large number of biologics currently available for moderate-to-severe psoriasis, poor adherence and persistence to therapy represent the main issues for both the clinical and economic management of psoriasis. However, the data about adherence and persistence to biologics in psoriasis patients are conflicting. Our aim was to produce summary estimates of adherence and persistence to biologics in adult patients with psoriasis. We performed a systematic review and meta-analysis of observational studies, searching two databases (PubMed and Embase). Sixty-two records met the inclusion criteria, and a meta-analysis was conducted on fifty-five studies. Overall, the proportion of adherent and persistent patients to biological therapy was 0.61 (95% confidence interval: 0.48–0.73) and 0.63 (0.57–0.68), respectively. The highest proportions were found for ustekinumab, while the lowest ones were found for etanercept. The proportions of adherence and persistence to biological drugs in psoriasis patients are sub-optimal. Notably, both proportions largely differ between drugs, suggesting that a more rational use of biologics might ensure better management of psoriasis.
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Anghel F, Nitusca D, Cristodor P. Body Mass Index Influence for the Personalization of the Monoclonal Antibodies Therapy for Psoriasis. Life (Basel) 2021; 11:1316. [PMID: 34947847 PMCID: PMC8703749 DOI: 10.3390/life11121316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/01/2021] [Accepted: 11/26/2021] [Indexed: 02/08/2023] Open
Abstract
Psoriasis is a chronic inflammatory, autoimmune-mediated disease that affects millions of individuals worldwide. Advances in treatment with biological agents represented by monoclonal antibodies, such as TNF-α inhibitors (TNFI), IL-17A and IL-12/23 antagonists have not only benefited from outstanding clinical efficacy with lower side effects compared to conventional systemic therapy, but also raised the standards towards therapeutic success, fact reflected in the greater Psoriasis Area and Severity Index (PASI) response rates. However, due to their relatively recent introduction in clinical practice, and despite their proven superior efficacy, further research is needed for monitoring the eventual changes in treatment-induced parameters, especially of metabolic origin. In this respect, initial reports stress on one particular comorbidity associated with psoriasis-obesity-which seems to be not only a risk and result of the disease, but also an adverse effect of long-term therapy with some biologics. The consequent drug-induced increase in body mass index (BMI) of patients suffering from psoriasis undergoing biological treatment appears to contribute to the progression of the disease, promote drug discontinuation and reduce overall clinical efficacy of monoclonal antibodies. Therefore, we review herein the impact of body weight (BMI) increase on the biological treatment of psoriasis, to further investigate on its relationship with the disease and aid on the management of treatment schemes that take into account individual characteristics of patients, such as body mass, for a more efficient and personalized therapy approach.
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Affiliation(s)
- Flavia Anghel
- Department of Biochemistry and Pharmacology, “Victor Babe” University of Medicine and Pharmacy, Pta Eftimie Murgu Nr. 2, 300041 Timişoara, Romania; (F.A.); (D.N.)
| | - Diana Nitusca
- Department of Biochemistry and Pharmacology, “Victor Babe” University of Medicine and Pharmacy, Pta Eftimie Murgu Nr. 2, 300041 Timişoara, Romania; (F.A.); (D.N.)
- Center for Complex Networks Science, “Victor Babe” University of Medicine and Pharmacy, Pta Eftimie Murgu Nr. 2, 300041 Timişoara, Romania
| | - Patricia Cristodor
- Department of Dermatology and Venerology, “Victor Babe” University of Medicine and Pharmacy, Pta Eftimie Murgu Nr. 2, 300041 Timişoara, Romania
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Inclisiran: A Novel Agent for Lowering Apolipoprotein B-Containing Lipoproteins. J Cardiovasc Pharmacol 2021; 78:e157-e174. [PMID: 33990512 DOI: 10.1097/fjc.0000000000001053] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/24/2021] [Indexed: 12/19/2022]
Abstract
ABSTRACT Hypercholesterolemia is a leading cause of cardiovascular morbidity and mortality. Accordingly, efforts to lower apolipoprotein B-containing lipoproteins in plasma are the centerpiece of strategies for cardiovascular prevention and treatment in primary and secondary management. Despite the importance of this endeavor, many patients do not achieve appropriate low density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein cholesterol (non-HDL-C) goals, even among those who have experienced atherosclerotic cardiovascular disease (ASCVD). The development of new LDL-C-lowering medications with alternative mechanisms of action will facilitate improved goal achievement in high risk patients. Inclisiran is a novel small interfering ribonucleic acid (siRNA)-based drug that is experimental in the US and approved for clinical use in the EU. It lowers LDL-C and other apolipoprotein B-containing lipoproteins by reducing production of Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9), a protein that normally contributes to LDL-receptor (LDLR) degradation, thereby increasing LDLR density and recycling in hepatocytes. Although the lipid-lowering efficacy of inclisiran is comparable to results achieved with PCSK9-blocking monoclonal antibodies (PCSK9i) (alirocumab and evolocumab), there are several important differences between the two drug classes. First, inclisiran reduces levels of PCSK9 both intracellularly and extracellularly by blocking translation of and degrading PCSK9 messenger RNA. Second, the long biological half-life of inclisiran produces sustained LDL-C-lowering with twice yearly dosing. Third, although PCSK9i drugs are proven to reduce ASCVD events, clinical outcomes trials with inclisiran are still in progress. In this manuscript, we review the clinical development of inclisiran, its mechanism of action, lipid-lowering efficacy, safety and tolerability, and potential clinical role of this promising new agent.
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7
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Wang Q, Luo Y, Lv C, Zheng X, Zhu W, Chen X, Shen M, Kuang Y. Nonadherence to Treatment and Patient-Reported Outcomes of Psoriasis During the COVID-19 Epidemic: A Web-Based Survey. Patient Prefer Adherence 2020; 14:1403-1409. [PMID: 32884243 PMCID: PMC7431943 DOI: 10.2147/ppa.s263843] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/16/2020] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The COVID-19 epidemic has caused difficulties in continuous treatment for patients with chronic diseases and resulted in nonadherence to treatment and adverse health outcomes. This study aimed to investigate the associations of nonadherence to treatment with patient-reported outcomes of psoriasis during the COVID-2019 epidemic. METHODS A cross-sectional study among Chinese patients with psoriasis was conducted through a web-based questionnaire survey during 25 Feb 2020 and 6 Mar 2020. Demographic and clinical data, nonadherence to treatment, and patient-reported outcomes were collected. The outcomes included deterioration of the disease condition, perceived stress, and symptoms of anxiety and depression. Logistic regression was used to investigate the associations. RESULTS A total of 926 questionnaires were collected. A total of 634 (68.5%) reported nonadherence to treatment, and worse adherence was found among patients receiving systemic treatment (adjusted odds ratio [AOR]: 2.67; 95% CI: 1.40-5.10) and topical treatment (AOR: 4.51; 95% CI: 2.66-7.65) compared to biological treatment. Nonadherence to treatment (less than two weeks and more than two weeks) was significantly associated with deterioration of psoriasis (aOR: 2.83 to 5.25), perceived stress (AOR: 1.86 to 1.57), and symptoms of anxiety (AOR: 1.42 to 1.57) and depression (AORs: 1.78). Subgroup analysis by treatment showed consistent results in general. CONCLUSION Nonadherence to treatment was associated with the aggravation of psoriasis conditions, perceived stress, and symptoms of anxiety and depression.
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Affiliation(s)
- Qiaolin Wang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha410008, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha410008, People’s Republic of China
- Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Changsha410008, People’s Republic of China
| | - Yan Luo
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha410008, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha410008, People’s Republic of China
- Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Changsha410008, People’s Republic of China
| | - Chengzhi Lv
- Department of Psoriasis, Dalian Dermatosis Hospital, Dalian, Liaoning116021, People’s Republic of China
| | - Xuanwei Zheng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha410008, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha410008, People’s Republic of China
- Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Changsha410008, People’s Republic of China
| | - Wu Zhu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha410008, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha410008, People’s Republic of China
- Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Changsha410008, People’s Republic of China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha410008, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha410008, People’s Republic of China
- Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Changsha410008, People’s Republic of China
| | - Minxue Shen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha410008, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha410008, People’s Republic of China
- Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Changsha410008, People’s Republic of China
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha410078, People’s Republic of China
| | - Yehong Kuang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha410008, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha410008, People’s Republic of China
- Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis (Xiangya Hospital), Changsha410008, People’s Republic of China
- Correspondence: Yehong Kuang; Minxue Shen Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, People’s Republic of China Email ;
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Mocanu M, Toader MP, Rezus E, Taranu T. Aspects concerning patient adherence to anti-TNFα therapy in psoriasis: A decade of clinical experience. Exp Ther Med 2019; 18:4987-4992. [PMID: 31798720 PMCID: PMC6880362 DOI: 10.3892/etm.2019.8008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 08/06/2019] [Indexed: 12/30/2022] Open
Abstract
Non-adherence to psoriasis treatment has an important impact in controlling chronic disease evolution and the occurrence of systemic comorbidities. Biologic therapy represents a revolutionary treatment, many of the undesirable psychological and socio-economical consequences of conventional topical or systemic therapies being avoided. Nevertheless, the discontinuation of biological therapy may occur due to facts related to the patient, to the lack of good communication between the patient and the physician or to the adverse or paradoxical reactions. We studied the non-adherence reasons to anti-TNFα agents (Infliximab, Adalimumab, Etanercept) used for treating 84 cases with moderate-severe psoriasis. The results of our study over the past 10 years showed a 76.2% adherence rate, lowest in patients treated with Etanercept (70.9%). Relative to the anti-TNF agent used, the highest adherence rate was recorded in Adalimumab (80.8%), followed by Infliximab (76.5%) and Etanercept (70.9%). We have noticed differences between the rates of adhesion to therapy with different anti-TNFα agents, but with no statistical significance. The main adverse effects that occurred during anti-TNFα therapy were: local reaction to the drug, mild infectious events, allergic reactions, cardiotoxicity, alopecia areata, pancreatitis, eosinophilia, thrombocytopenia. Anti-TNF therapy was discontinued in one case of endocarditis, one case with tuberculous laryngitis and another one with polydiscitis (Adalimumab), a case of colon cancer and one of pregnancy (Etanercept) and one paradoxical reaction (Infliximab).
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Affiliation(s)
- Madalina Mocanu
- Dermatology Clinic, Railways University Hospital Iasi, 'Grigore T. Popa' University of Medicine and Pharmacy, 700506 Iasi, Romania
| | - Mihaela-Paula Toader
- Dermatology Clinic, Railways University Hospital Iasi, 'Grigore T. Popa' University of Medicine and Pharmacy, 700506 Iasi, Romania
| | - Elena Rezus
- Rheumatology Clinic, University Rehabilitation Hospital, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Tatiana Taranu
- Dermatology Clinic, Railways University Hospital Iasi, 'Grigore T. Popa' University of Medicine and Pharmacy, 700506 Iasi, Romania
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Eicher L, Knop M, Aszodi N, Senner S, French LE, Wollenberg A. A systematic review of factors influencing treatment adherence in chronic inflammatory skin disease - strategies for optimizing treatment outcome. J Eur Acad Dermatol Venereol 2019; 33:2253-2263. [PMID: 31454113 DOI: 10.1111/jdv.15913] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 08/08/2019] [Indexed: 12/23/2022]
Abstract
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.
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Affiliation(s)
- L Eicher
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, Munich, Germany
| | - M Knop
- Derma I, München Klinik, Munich, Germany
| | - N Aszodi
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, Munich, Germany
| | - S Senner
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, Munich, Germany
| | - L E French
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, Munich, Germany.,Derma I, München Klinik, Munich, Germany
| | - A Wollenberg
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, Munich, Germany.,Derma I, München Klinik, Munich, Germany
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Mourad A, Straube S, Armijo‐Olivo S, Gniadecki R. Factors predicting persistence of biologic drugs in psoriasis: a systematic review and meta‐analysis. Br J Dermatol 2019; 181:450-458. [DOI: 10.1111/bjd.17738] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2019] [Indexed: 01/19/2023]
Affiliation(s)
- A. Mourad
- Faculty of Medicine & Dentistry University of Alberta Medical School Edmonton ABCanada
| | - S. Straube
- Division of Preventive Medicine University of Alberta Edmonton ABCanada
| | - S. Armijo‐Olivo
- Research Center Faculty of Rehabilitation Medicine University of Alberta Edmonton ABCanada
| | - R. Gniadecki
- Division of Dermatology Department of Medicine University of Alberta Edmonton AB Canada
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Lunder T, Zorko MS, Kolar NK, Suhodolcan AB, Marovt M, Leskovec NK, Marko PB. Drug survival of biological therapy is showing class effect: updated results from Slovenian National Registry of psoriasis. Int J Dermatol 2019; 58:631-641. [DOI: 10.1111/ijd.14429] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/16/2019] [Accepted: 02/18/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Tomaz Lunder
- Department of Dermatovenereology University Medical Centre Ljubljana Ljubljana Slovenia
- Medical Faculty University of Ljubljana Ljubljana Slovenia
| | - Mateja S. Zorko
- Department of Dermatovenereology University Medical Centre Ljubljana Ljubljana Slovenia
- Medical Faculty University of Ljubljana Ljubljana Slovenia
| | - Natasa K. Kolar
- Department of Dermatovenereology Celje General Hospital Celje Slovenia
| | - Aleksandra B. Suhodolcan
- Department of Dermatovenereology University Medical Centre Ljubljana Ljubljana Slovenia
- Medical Faculty University of Ljubljana Ljubljana Slovenia
| | - Maruska Marovt
- Department of Dermatovenereology University Medical Centre Maribor MariborSlovenia
| | - Nada K. Leskovec
- Medical Faculty University of Ljubljana Ljubljana Slovenia
- Remeda, Medical Centre Domzale Slovenia
| | - Pij B. Marko
- Department of Dermatovenereology University Medical Centre Maribor MariborSlovenia
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Lin PT, Wang SH, Chi CC. Drug survival of biologics in treating psoriasis: a meta-analysis of real-world evidence. Sci Rep 2018; 8:16068. [PMID: 30375427 PMCID: PMC6207685 DOI: 10.1038/s41598-018-34293-y] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 10/16/2018] [Indexed: 02/08/2023] Open
Abstract
Drug survival of biologics represents their real-world effectiveness and safety. We conducted a meta-analysis of real-world evidence on the drug survival of biologics in treating psoriasis. We searched the PubMed, CENTRAL, and EMBASE databases from inception to 7th October 2017 for studies reporting the annual drug survival for at least 1 year. Two authors independently screened and selected relevant studies, and assessed their risk of bias. A third author was available for arbitrating discrepancies. We conducted a random-effects model meta-analysis to obtain the respective pooled drug survival from year 1 to 4. We conducted subgroup analysis on biologic-naïve subjects, discontinuation for loss of efficacy and adverse effects. We included 37 studies with 32,631 subjects. The drug survival for all biologics decreased with time, dropping from 66% at year 1 to 41% at year 4 for etanercept, from 69% to 47% for adalimumab, from 61% to 42% for infliximab, and from 82% to 56% for ustekinumab. Ustekinumab was associated with the highest drug survival in all and biologic-naïve subjects. Etanercept was associated with the lowest drug survival and was most commonly discontinued for loss of efficacy. Infliximab was most frequently associated with discontinuation for adverse effects. Clinicians may use this study as a reference in treating psoriasis.
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Affiliation(s)
- Pei-Tzu Lin
- Department of Pharmacy, Chang Gung Memorial Hospital, Chiayi, Chiayi, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Shu-Hui Wang
- Department of Dermatology, Far Eastern Memorial Hospital, New Taipei, Taiwan.,Graduate Institute of Applied Science and Engineering, College of Science and Engineering, Fu Jen Catholic University, New Taipei, Taiwan
| | - Ching-Chi Chi
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan. .,College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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13
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Aleshaki JS, Cardwell LA, Muse ME, Feldman SR. Adherence and resource use among psoriasis patients treated with biologics. Expert Rev Pharmacoecon Outcomes Res 2018; 18:609-617. [DOI: 10.1080/14737167.2018.1512408] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Joseph S. Aleshaki
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Leah A. Cardwell
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mikél E. Muse
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Steven R. Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
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14
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Costanzo A, Malara G, Pelucchi C, Fatiga F, Barbera G, Franchi A, Galeone C. Effectiveness End Points in Real-World Studies on Biological Therapies in Psoriasis: Systematic Review with Focus on Drug Survival. Dermatology 2018; 234:1-12. [DOI: 10.1159/000488586] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/17/2018] [Indexed: 12/26/2022] Open
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15
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Arnold T, Schaarschmidt ML, Herr R, Fischer JE, Goerdt S, Peitsch WK. Drug survival rates and reasons for drug discontinuation in psoriasis. J Dtsch Dermatol Ges 2018; 14:1089-1099. [PMID: 27879076 DOI: 10.1111/ddg.13152] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 06/04/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVES Moderate-to-severe psoriasis frequently requires long-term systemic therapy. Reflecting efficacy, safety, and treatment satisfaction, drug survival is an indicator of therapeutic success. The objective of the present study was to assess drug survival rates and reasons for discontinuation of fumaric acid esters (FAE), methotrexate (MTX), acitretin (ACI), cyclosporine A (CyA), adalimumab (ADA), etanercept (ETA), infliximab (INF), and ustekinumab (UST) in patients with moderate-to-severe psoriasis. PATIENTS AND METHODS We performed a retrospective analysis of 373 patients who had received a total of 696 treatment courses at a German university hospital in the period 1/2003-5/2014. RESULTS The crude probability of survival was highest for UST, followed by ADA, ETA, INF, FAE, MTX, ACI, and CyA. In multivariate regression analysis using FAE as reference, hazard ratios (HR) for discontinuation were 0.14 (95 % confidence interval: 0.06-0.35) for UST, 0.43 (0.26-0.73) for ADA, 2.11 (1.14-3.91) for ACI, and 3.26 (1.44-7.39) for CyA. INF showed longer survival when combined with MTX (HR 2.87, 1.21-6.81). Traditional systemic antipsoriatic agents as well as INF were most frequently discontinued due to adverse events; all other biologics, due to inefficacy with respect to cutaneous lesions. CONCLUSIONS Drug survival rates should be integrated into therapeutic decisions in order to provide patients with an optimal long-term strategy.
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Affiliation(s)
- Tobias Arnold
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Marthe-Lisa Schaarschmidt
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Raphael Herr
- Mannheim Institute of Public Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Joachim E Fischer
- Mannheim Institute of Public Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sergij Goerdt
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Wiebke K Peitsch
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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16
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Abstract
INTRODUCTION Psoriasis has a profound impact on patients' lives, but adherence to topical treatment of psoriasis is still poor. Biologic treatment has revolutionized the management of psoriasis, but adherence to treatment may still be a barrier for some patients. Areas covered: A PubMed search was conducted in August 2017 using the terms 'biologics psoriasis adherence' and 'biologics psoriasis survival.' Additional articles were obtained by perusing the references of articles identified in the original PubMed search. Articles that did not specifically mention 'survival,' 'adherence,' or 'persistence' were not included. We review the measures used to assess adherence to biologics for psoriasis and the factors impacting drug survival and adherence rates for biologics in psoriasis. Expert commentary: Drug survival and adherence rates for biologic therapy is less than ideal but may be modifiable. Means that may improve adherence and drug survival include individualized choice of biologic and providing additional support for patients who are at increased risk for prematurely stopping treatment.
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Affiliation(s)
- Lauren Seale
- a Center for Dermatology Research, Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - Leah A Cardwell
- a Center for Dermatology Research, Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - Steven R Feldman
- a Center for Dermatology Research, Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA.,b Department of Pathology , Wake Forest School of Medicine , Winston-Salem , NC , USA.,c Department of Social Sciences & Health Policy , Wake Forest School of Medicine , Winston-Salem , NC , USA
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17
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Carretero G, Puig L, Carrascosa JM, Ferrándiz L, Ruiz-Villaverde R, de la Cueva P, Belinchon I, Vilarrasa E, Del Rio R, Sánchez-Carazo JL, López-Ferrer A, Peral F, Armesto S, Eiris N, Mitxelena J, Vilar-Alejo J, A Martin M, Soria C. Redefining the therapeutic objective in psoriatic patients candidates for biological therapy. J DERMATOL TREAT 2017; 29:334-346. [PMID: 29099667 DOI: 10.1080/09546634.2017.1395794] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The advances in psoriasis management currently allow achieving a good control of the disease. In particular, with the latest developed molecules, available evidence suggests that it is possible to pose an ambitious therapeutic goal, such as a Dermatology Life Quality Index 0/1, a Physician Global Assessment 0/1, or a Psoriasis Area and Severity Index 90/100 response. However, patients often fail to achieve the complete clearance of their cutaneous lesions or the improvement of disease factors that impair their quality of life. To optimize the treatment of psoriasis, it is not enough to define precisely the therapeutic objective, but also to adapt the therapeutic strategy to make the necessary modifications in case of not achieving it at the time point (at the end of the induction phase, or every 3-6 months) to be agreed with the patient (the so-called treat-to-target approach). In the present report, based on the Delphi methodology, 11 dermatologists from the Spanish Psoriasis Group addressed key issues that could be involved in the achievement and maintenance of the therapeutic goals of patients with moderate to severe psoriasis. The document provides 27 consensus statements intended to support clinical decision-making by healthcare professionals for patients who might be candidates to receive biologic therapy.
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Affiliation(s)
- G Carretero
- a Hospital Universitario de Gran Canaria Doctor Negrín , Las Palmas de Gran Canaria , Spain
| | - L Puig
- b Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona , Barcelona , Spain
| | - J M Carrascosa
- c Hospital Universitari Germans Trias I Pujol, Universitat Autònoma de Barcelona , Badalona , Spain
| | - L Ferrándiz
- d Hospital Universitario Virgen Macarena , Sevilla , Spain
| | | | - P de la Cueva
- f Hospital Universitario Infanta Leonor , Madrid , Spain
| | - I Belinchon
- g Hospital General Universitario de Alicante-ISABIAL , Alicante , Spain
| | - E Vilarrasa
- b Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona , Barcelona , Spain
| | - R Del Rio
- h Fundació Hospital L'Esperit Sant , Santa Coloma de Gramenet , Spain
| | | | - A López-Ferrer
- b Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona , Barcelona , Spain
| | - F Peral
- j Hospital Universitario Infanta Cristina de Badajoz , Badajoz , Spain
| | - S Armesto
- k Hospital Universitario Marqués de Valdecilla , Santander , Spain
| | - N Eiris
- l Complejo Asistencial Universitario de León , Spain
| | | | - J Vilar-Alejo
- a Hospital Universitario de Gran Canaria Doctor Negrín , Las Palmas de Gran Canaria , Spain
| | - M A Martin
- n Hospital Clínico Universitario Lozano Blesa , Zaragoza , Spain
| | - C Soria
- o Hospital General Universitario Reina Sofia , Murcia , Spain
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18
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ITK and RLK Inhibitor PRN694 Improves Skin Disease in Two Mouse Models of Psoriasis. J Invest Dermatol 2017; 138:864-871. [PMID: 29129599 DOI: 10.1016/j.jid.2017.10.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 10/03/2017] [Accepted: 10/23/2017] [Indexed: 12/22/2022]
Abstract
The chronic and highly prevalent skin disorder psoriasis vulgaris is characterized by a hyperproliferative epidermis and aberrant immune activity. Many studies have highlighted the role of differentiated T lymphocytes in psoriasis progression. Several biologics are currently available that target proinflammatory cytokines produced by T lymphocytes, but the need for improved therapies persists. The small molecule PRN694 covalently binds ITK and RLK, two Tec kinases activated downstream of T-lymphocyte activation, both of which are up-regulated in psoriatic skin. These Tec kinases are involved in signaling cascades mediating T-lymphocyte proliferation, differentiation, and migration and proinflammatory cytokine production. In vitro analysis showed that PRN694 effectively inhibited IL-17A production from murine T helper type 17-differentiated T lymphocytes. Additionally, PRN694 effectively reduced the psoriasis-like phenotype severity and reduced epidermal proliferation and thickness in both the Rac1V12 and imiquimod mouse models of psoriasis. PRN694 also inhibited CD3+ T-cell and γδ T-cell infiltration into skin regions. Inhibition of ITK and RLK attenuated psoriasis-associated signaling pathways, indicating that PRN694 is an effective psoriasis therapeutic.
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19
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No DJ, Inkeles MS, Amin M, Wu JJ. Drug survival of biologic treatments in psoriasis: a systematic review. J DERMATOL TREAT 2017; 29:460-466. [PMID: 29076754 DOI: 10.1080/09546634.2017.1398393] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Drug survival measures the length of time until discontinuation of a drug. The length of time a patient remains on a biologic drug is impacted by several factors such as tolerability, side effects, safety profile and effectiveness. To evaluate the long-term drug survival, data of the most commonly prescribed biologic medications used in the treatment of psoriasis, a systematic review was conducted. A literature search using PubMed, the Cochrane Library and the Cumulative Index to Nursing and Allied Health Literature from January 1 2010 to October 28 2016 identified 3734 abstracts. Of which, 36 publications with over 40,000 patients met the inclusion criteria. The median overall drug survival for ustekinumab, adalimumab, infliximab and etanercept was 38.0, 36.5, 26.6 and 24.7 months, respectively. The mean annual drug survival rate of TNF inhibitors was 70%, 57%, 51%, 45% and 41% at years-1, 2, 3, 4 and 5, respectively. The 5-year mean annual drug survival rate of ustekinumab was 87%, 78%, 70%, 71% and 51%, respectively. Based on our findings, ustekinumab appears to have a longer drug survival with lower rates of discontinuation compared to tumor necrosis factor inhibitors.
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Affiliation(s)
- Daniel J No
- a Dermatology , Loma Linda University School of Medicine , Loma Linda , CA , USA
| | - Megan S Inkeles
- b Internal Medicine , Kaiser Permanente Los Angeles Medical Center , Los Angeles , CA , USA
| | - Mina Amin
- c Dermatology , University of California Riverside School of Medicine , Riverside , CA , USA
| | - Jashin J Wu
- d Department of Dermatology , Kaiser Permanente Los Angeles Medical Center , Los Angeles , CA , USA
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20
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Pogácsás L, Borsi A, Takács P, Remenyik É, Kemény L, Kárpáti S, Holló P, Wikonkál N, Gyulai R, Károlyi Z, Rakonczai P, Balázs T, Szegedi A. Long-term drug survival and predictor analysis of the whole psoriatic patient population on biological therapy in Hungary. J DERMATOL TREAT 2017; 28:635-641. [DOI: 10.1080/09546634.2017.1329504] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Lilla Pogácsás
- Division of Dermatological Allergology, University of Debrecen, Debrecen, Hungary
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - András Borsi
- Department of Health Economics, Market Access and Reimbursement, Janssen-Cilag Hungary Ltd., Budapest, Hungary
| | - Péter Takács
- Real World Evidence Centre of Excellence, Janssen-Cilag Hungary Ltd., Budapest, Hungary
| | - Éva Remenyik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Lajos Kemény
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Sarolta Kárpáti
- Department of Dermatovenerology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Péter Holló
- Department of Dermatovenerology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Norbert Wikonkál
- Department of Dermatovenerology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Rolland Gyulai
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs, Pécs, Hungary
| | | | - Pál Rakonczai
- Department of Research and Analysis, Healthware Consulting Ltd., Budapest, Hungary
| | - Tamás Balázs
- Department of Research and Analysis, Healthware Consulting Ltd., Budapest, Hungary
| | - Andrea Szegedi
- Division of Dermatological Allergology, University of Debrecen, Debrecen, Hungary
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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21
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Zschocke I, Ortland C, Reich K. Evaluation of adherence predictors for the treatment of moderate to severe psoriasis with biologics: the importance of physician-patient interaction and communication. J Eur Acad Dermatol Venereol 2017; 31:1014-1020. [DOI: 10.1111/jdv.14178] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 02/06/2017] [Indexed: 10/20/2022]
Affiliation(s)
| | - C. Ortland
- Das forschungsdock Service for clinical development; Schenefeld Germany
| | - K. Reich
- Dermatologikum Hamburg; Hamburg Germany
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22
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Arnold T, Schaarschmidt M, Herr R, Fischer JE, Goerdt S, Peitsch WK. „Drug‐Survival“‐Raten und Gründe für den Abbruch von Systemtherapien bei Psoriasis. J Dtsch Dermatol Ges 2016; 14:1090-1101. [DOI: 10.1111/ddg.13152_g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 06/04/2016] [Indexed: 12/29/2022]
Affiliation(s)
- Tobias Arnold
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg Mannheim
| | - Marthe‐Lisa Schaarschmidt
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg Mannheim
| | - Raphael Herr
- Mannheimer Institut für Public Health, Sozial‐ und Präventivmedizin Medizinische Fakultät Mannheim, Universität Heidelberg Mannheim
| | - Joachim E. Fischer
- Mannheimer Institut für Public Health, Sozial‐ und Präventivmedizin Medizinische Fakultät Mannheim, Universität Heidelberg Mannheim
| | - Sergij Goerdt
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg Mannheim
| | - Wiebke K. Peitsch
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg Mannheim
- Klinik für Dermatologie und Phlebologie Vivantes Klinikum im Friedrichshain Berlin
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23
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Marinas JEC, Kim WB, Shahbaz A, Qiang JK, Greaves S, Yeung J. Survival rates of biological therapies for psoriasis treatment in real-world clinical practice: A Canadian multicentre retrospective study. Australas J Dermatol 2016; 59:e11-e14. [DOI: 10.1111/ajd.12548] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 07/14/2016] [Indexed: 12/26/2022]
Affiliation(s)
- Joseph EC Marinas
- Department of Health Sciences; Michael G. DeGroote School of Medicine; McMaster University; Hamilton Ontario Canada
| | - Whan B Kim
- Department of Health Sciences; Michael G. DeGroote School of Medicine; McMaster University; Hamilton Ontario Canada
| | - Ali Shahbaz
- Department of Medicine; School of Medicine; University of Ottawa; Ottawa Ontario Canada
| | - Judy K Qiang
- Department of Medicine; School of Medicine; University of Toronto; Toronto Ontario Canada
| | - Simon Greaves
- Dalla Lana School of Public Health; University of Toronto; Toronto Ontario Canada
| | - Jensen Yeung
- Division of Dermatology; Department of Medicine; University of Toronto; Toronto Ontario Canada
- Department of Dermatology; Sunnybrook Health Sciences Centre; Toronto Ontario Canada
- Department of Dermatology; Women's College Hospital; Toronto Ontario Canada
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24
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Zweegers J, van den Reek J, van de Kerkhof P, Otero M, Kuijpers A, Koetsier M, Arnold W, Berends M, Weppner-Parren L, Ossenkoppele P, Njoo M, Mommers J, van Lümig P, Driessen R, Kievit W, de Jong E. Body mass index predicts discontinuation due to ineffectiveness and female sex predicts discontinuation due to side-effects in patients with psoriasis treated with adalimumab, etanercept or ustekinumab in daily practice: a prospective, comparative, long-t. Br J Dermatol 2016; 175:340-7. [DOI: 10.1111/bjd.14552] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2016] [Indexed: 12/27/2022]
Affiliation(s)
- J. Zweegers
- Department of Dermatology; Biostatistics and Health Technology Assessment; Radboud University Medical Center; Nijmegen the Netherlands
| | - J.M.P.A. van den Reek
- Department of Dermatology; Biostatistics and Health Technology Assessment; Radboud University Medical Center; Nijmegen the Netherlands
| | - P.C.M. van de Kerkhof
- Department of Dermatology; Biostatistics and Health Technology Assessment; Radboud University Medical Center; Nijmegen the Netherlands
| | - M.E. Otero
- Department of Dermatology; Biostatistics and Health Technology Assessment; Radboud University Medical Center; Nijmegen the Netherlands
| | | | | | - W.P. Arnold
- Ziekenhuis Gelderse Vallei; Ede the Netherlands
| | | | | | | | - M.D. Njoo
- Ziekenhuisgroep Twente; Almelo Hengelo the Netherlands
| | | | - P.P.M. van Lümig
- Department of Dermatology; Biostatistics and Health Technology Assessment; Radboud University Medical Center; Nijmegen the Netherlands
| | - R.J.B. Driessen
- Department of Dermatology; Biostatistics and Health Technology Assessment; Radboud University Medical Center; Nijmegen the Netherlands
| | - W. Kievit
- Department of Epidemiology; Biostatistics and Health Technology Assessment; Radboud University Medical Center; Nijmegen the Netherlands
| | - E.M.G.J. de Jong
- Department of Dermatology; Biostatistics and Health Technology Assessment; Radboud University Medical Center; Nijmegen the Netherlands
- Radboud University; Nijmegen the Netherlands
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25
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Magis Q, Jullien D, Gaudy-Marqueste C, Baumstark K, Viguier M, Bachelez H, Guibal F, Delaporte E, Karimova E, Montaudié H, Boye T, Aubin F, Beylot-Barry M, Richard MA. Predictors of long-term drug survival for infliximab in psoriasis. J Eur Acad Dermatol Venereol 2016; 31:96-101. [DOI: 10.1111/jdv.13747] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 03/25/2016] [Indexed: 01/24/2023]
Affiliation(s)
- Q. Magis
- Department of Dermatology; Hôpital Timone; Assistance Publique des Hôpitaux de Marseille; UMR 911; INSERM CRO2; “Centre de recherche en oncologie biologique et onco phamacologie”; Aix-Marseille University; Marseille France
| | - D. Jullien
- Department of Dermatology Hôpital Edouard Herriot; University Claude Bernard Lyon-1; University of Lyon; Lyon France
| | - C. Gaudy-Marqueste
- Department of Dermatology; Hôpital Timone; Assistance Publique des Hôpitaux de Marseille; UMR 911; INSERM CRO2; “Centre de recherche en oncologie biologique et onco phamacologie”; Aix-Marseille University; Marseille France
| | - K. Baumstark
- Clinical Research Platform; Assistance Publique des Hôpitaux de Marseille; EA 3279 “Qualité de vie et maladies chroniques”; Aix-Marseille University; Marseille France
| | - M. Viguier
- Department of Dermatology; AP-HP Hôpital Saint Louis; University Paris Diderot; Sorbonne Paris Cité; Paris France
| | - H. Bachelez
- Department of Dermatology; AP-HP Hôpital Saint Louis; University Paris Diderot; Sorbonne Paris Cité; Paris France
| | - F. Guibal
- Department of Dermatology; AP-HP Hôpital Saint Louis; University Paris Diderot; Sorbonne Paris Cité; Paris France
| | | | | | | | - T. Boye
- Hôpital d'instruction des armées St Anne; Toulon France
| | - F. Aubin
- Regional University Hospital Hôpital Jean Minjoz; Besançon France
| | - M. Beylot-Barry
- Department of Dermatology; Hôpital Saint-André; University of Bordeaux; Bordeaux France
| | - M.-A. Richard
- Department of Dermatology; Hôpital Timone; Assistance Publique des Hôpitaux de Marseille; UMR 911; INSERM CRO2; “Centre de recherche en oncologie biologique et onco phamacologie”; Aix-Marseille University; Marseille France
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26
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Hoffman MB, Hill D, Feldman SR. Current challenges and emerging drug delivery strategies for the treatment of psoriasis. Expert Opin Drug Deliv 2016; 13:1461-73. [PMID: 27164301 DOI: 10.1080/17425247.2016.1188801] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Psoriasis is a common skin disorder associated with physical, social, psychological and financial burden. Over the past two decades, advances in our understanding of pathogenesis and increased appreciation for the multifaceted burden of psoriasis has led to new treatment development and better patient outcomes. Yet, surveys demonstrate that many psoriasis patients are either undertreated or are dissatisfied with treatment. There are many barriers that need be overcome to optimize patient outcomes and satisfaction. AREAS COVERED This review covers the current challenges associated with each major psoriasis treatment strategy (topical, phototherapy, oral medications and biologics). It also reviews the challenges associated with the psychosocial aspects of the disease and how they affect treatment outcomes. Patient adherence, inconvenience, high costs, and drug toxicities are all discussed. Then, we review the emerging drug delivery strategies in topical, oral, and biologic therapy. EXPERT OPINION By outlining current treatment challenges and emerging drug delivery strategies, we hope to highlight the deficits in psoriasis treatment and strategies for how to overcome them. Regardless of disease severity, clinicians should use a patient-centered approach. In all cases, we need to balance patients' psychosocial needs, treatment costs, convenience, and effectiveness with patients' preferences in order to optimize treatment outcomes.
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Affiliation(s)
- Melissa B Hoffman
- a Center for Dermatology Research, Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - Dane Hill
- a Center for Dermatology Research, Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - Steven R Feldman
- a Center for Dermatology Research, Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA.,b Department of Pathology , Wake Forest School of Medicine , Winston-Salem , NC , USA.,c Department of Public Health Sciences , Wake Forest School of Medicine , Winston-Salem , NC , USA
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Rouse NC, Farhangian ME, Wehausen B, Feldman SR. The cost-effectiveness of ustekinumab for moderate-to-severe psoriasis. Expert Rev Pharmacoecon Outcomes Res 2015; 15:877-84. [PMID: 26488186 DOI: 10.1586/14737167.2015.1102634] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Given its chronicity and impact on quality of life, psoriasis is a costly disease. As new and better treatments are developed, the cost of treating psoriasis has risen. In this drug profile, the authors discuss ustekinumab, its pharmacokinetics, safety profile, and direct and indirect costs to determine its cost-efficacy. The authors searched PubMed with specific search phrases for clinical trials investigating this issue over 5 years. Eleven articles analyzed cost-effectiveness of ustekinumab, and the references of these articles were included. Studies limited to 12 weeks reported that ustekinumab may not be cost-effective as it has high cost per injection and is costly when loading doses are required. Studies that went beyond 12 weeks documented that, with ustekinumab's infrequent dosing, it is cost-effective during the maintenance period.
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Affiliation(s)
- Nicole C Rouse
- a Department of Osteopathic and Neuromuscular Medicine, College of Osteopathic Medicine of the Pacific , Western University of Health Sciences , Pomona , CA , USA
| | - Michael E Farhangian
- b Center for Dermatology Research, Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - Brooke Wehausen
- b Center for Dermatology Research, Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - Steven R Feldman
- b Center for Dermatology Research, Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA.,c Department of Pathology , Wake Forest School of Medicine , Winston-Salem , NC , USA.,d Department of Public Health Sciences , Wake Forest School of Medicine , Winston-Salem , NC , USA
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