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Journal of the American Academy of Dermatology
Volume 74, n° 6
pages 1066-1072 (juin 2016)
Doi : 10.1016/j.jaad.2016.01.037
accepted : 25 January 2016
Original Articles

ORBIT (Outcome and Retention Rate of Biologic Treatments for Psoriasis): A retrospective observational study on biologic drug survival in daily practice
 

Eva Vilarrasa, MD a, Jaume Notario, MD c, Xavier Bordas, PhD c, Anna López-Ferrer, PhD a, Ignasi J. Gich, PhD b, Lluís Puig, PhD a,
a Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain 
b Department of Clinical Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain 
c Department of Dermatology, Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain 

Reprint requests: Lluís Puig, PhD, Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.Department of DermatologyHospital de la Santa Creu i Sant PauUniversitat Autònoma de BarcelonaBarcelona, CataloniaSpain
Abstract
Background

Biologic drug survival in psoriasis reflects long-term performance in real-life settings. Previous studies have yielded inconsistent results.

Objectives

We sought to analyze long-term biologic survival and its associated variables in a large, real-life cohort of patients with moderate to severe chronic plaque psoriasis.

Methods

This was an observational retrospective study. Data were extracted from clinical records of 427 patients treated with biologic agents over a 4-year period. Drug survival was analyzed using the Kaplan-Meier method and the influence of several covariates was assessed using Cox regression.

Results

We analyzed 703 treatment courses. Overall median drug survival was 31.0 months. Cumulative probability of drug survival was lower in obese patients (23.0 months, 95% confidence interval 17.4-28.6) than in patients with body mass index less than 30 (37.3 months, 95% confidence interval 29.4-45.1, P  = .001), and it was significantly higher for ustekinumab than for any other biologic agent (log rank test P  < .001). Multivariate analysis showed that obesity, etanercept treatment, and strict adherence to approved doses were associated with an increased probability of drug withdrawal, whereas ustekinumab treatment, and PASI75 and PASI90 responses at week 16 prolonged drug survival.

Limitations

Data were collected retrospectively.

Conclusions

These findings can facilitate the daily treatment of psoriatic patients and promote long-term effectiveness of biologic therapies.

The full text of this article is available in PDF format.

Key words : adalimumab, biologics: cohort, efficacy, etanercept, infliximab, psoriasis, real-life, survival, treatment, ustekinumab

Abbreviations used : ADA, BMI, CI, EMA, ETN, HR, IFX, PASI, SmPC, TNF, UST



 Supported by an unrestricted research grant (IISP-ORB-2013-84) from Novartis, Barcelona, Spain.
 Disclosure: Drs Vilarrasa, Notario, Bordas, and López-Ferrer have all received consultancy/speakers' honoraria and participated in clinical trials sponsored by Abbvie, Janssen, MSD, Novartis, and Pfizer. Dr Puig has received consultancy/speakers' honoraria and participated in clinical trials sponsored by Abbvie, Amgen, Janssen, Lilly, MSD, Novartis, and Pfizer. Dr Gich has no conflicts of interest to declare.



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