Biologic drug survival in Israeli psoriasis patients
Biologic drug survival in Israeli psoriasis patients
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DOI：
10.1016/j.jaad.2016.10.033
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发表时间：
2017-04-01
影响因子：
13.8
通讯作者：
Pavlovsky, Lev
中科院分区：
文献类型：
--
作者：
Shalom, Guy;Cohen, Arnon D.;Pavlovsky, Lev
背景：药物生存期定义为某种药物治疗直至停药的时间。以往暴露于传统的全身治疗的生物survival.Objective的作用：探讨药物的生物治疗在银屑病患者的生存率，并确定预测factors.Methods：生存分析进行了严重银屑病患者接受阿达木单抗，英夫利昔单抗，依那西普，乌司奴单抗治疗银屑病，从Clalit健康服务数据库。多变量分析进行调整人口统计学变量;代谢综合征及其组成部分;银屑病关节炎;生物天真;甲氨蝶呤，阿维A，或环孢素的共同管理;和以前的标准全身治疗exposure.Results：在907例患者与1575生物治疗，优特克单抗有一个显着较高的生存率比肿瘤坏死因子抑制剂。生物学幼稚和伴随甲氨蝶呤摄入是药物生存的阳性预测因子，而女性和既往系统治疗的持续时间是阴性预测因子。局限性：无法从Clalit Health Services数据库中获得关于疾病严重程度或持续时间的数据。与其他研究的生物制剂相比，乌司奴单抗在重度银屑病患者中具有更好的保留率，他们中的大多数人都把它作为第三线治疗。
Background: Drug survival is defined as the time period of treatment with a certain drug until its cessation. The role of previous exposure to traditional systemic treatments in biologic survival is still unknown.Objective: To investigate the drug survival rates of biologic treatments in patients with psoriasis and to identify predictor factors.Methods: Survival analysis was performed on patients with severe psoriasis who received adalimumab, infliximab, etanercept, and ustekinumab for treatment of psoriasis, drawn from the Clalit Health Services database. Multivariate analysis was performed adjusting for demographic variables; metabolic syndrome and its components; psoriatic arthritis; biologic naivety; coadministration of methotrexate, acitretin, or cyclosporine; and previous standard systemic treatment exposure.Results: Among 907 patients treated with 1575 biologic treatments, ustekinumab had a significantly higher survival rate than tumor necrosis factor inhibitors. Biologic naivety and concomitant methotrexate intake were positive predictors for drug survival, whereas the female sex and the duration of previous systemic treatments were negative predictors.Limitations: Data regarding disease severity or duration could not be drawn from the Clalit Health Services database.Conclusion: Ustekinumab had better retention rates in comparison with other investigated biologics in patients with severe psoriasis, most of whom used it as a third line therapy.