Survival of classic and biological systemic drugs in psoriasis: results of the BIOBADADERM registry and critical analysis
Por:
Davila-Seijo P, Dauden E, Carretero G, Ferrandiz C, Vanaclocha F, Gomez-Garcia FJ, Herrera-Ceballos E, De la Cueva-Dobao P, Belinchon I, Sanchez-Carazo JL, Alsina M, Lopez-Estebaranz JL, Ferran M, Torrado R, Carrascosa JM, Llamas M, Rivera R, Jimenez-Puya R, Garcia-Doval I and BIOBADADERM Study Group
Publicada:
1 nov 2016
Resumen:
BackgroundFew reported studies compare drug survival in
moderate-to-severe psoriasis vulgaris.
ObjectivesTo describe and compare drug survival of systemic drugs,
including biologic agents (infliximab, etanercept, adalimumab and
ustekinumab) and classical drugs (acitretin, ciclosporin and
methotrexate) in moderate-to-severe psoriasis.
MethodsThis was a multicenter, prospective, cohort study of patients
receiving systemic therapies between 2008 and 2013 in 12 hospitals in
Spain. Baseline data and drug discontinuation were collected. Drug
survival is presented using Kaplan-Meier survival curves. We compared
adjusted risk ratios of serious adverse events (AEs) with results of
survival analysis for AEs.
ResultsA total of 1956 patients were included for analysis (1240 exposed
to biologics during follow-up and 1076 to classic therapies). Median
follow-up time was 3.3 years (0.0-5.1 years). There were 2209
discontinuations out of 3640 therapy cycles started. The main reason for
discontinuation was lack of efficacy (36.4%) and remission (27.2%).
Biologics showed a higher drug survival than classics and the pattern of
survival results for all outcomes (positive or negative) were very
similar. Adjusted risk ratios of serious AEs did not agree with results
of survival analysis.
LimitationsA limitation is that this is an observational study with
potential selection bias.
ConclusionSurvival as a proxy measure of drug safety in psoriasis is
inadequate.
Filiaciones:
Davila-Seijo P:
Research Unit, Fundacion Academia Espanola de Dermatologia y Venereologia, Madrid, Spain.
Department of Dermatology, Hospital Universitario La Princesa, Madrid, Spain.
Department of Dermatology, Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas de Gran Canaria, Spain.
Department of Dermatology, Hospital Universitario Germans Trias i Pujol, Badalona, Spain.
Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain.
Department of Dermatology, Hospital Universitario Reina Sofia, Cordoba, Spain.
Department of Dermatology, Hospital Universitario Virgen de la Victoria, Malaga, Spain.
Department of Dermatology, Hospital Infanta Leonor, Madrid, Spain.
Department of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain.
Department of Dermatology, Hospital General Universitario de Valencia, Valencia, Spain.
Department of Dermatology, Hospital Clinic de Barcelona, Barcelona, Spain.
Department of Dermatology, Hospital Universitario Fundacion Alcorcon, Madrid, Spain.
Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.
Department of Dermatology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain.
Department of Dermatology and Venereology, Umea University Hospital, Umea, Sweden.
Dauden E:
Department of Dermatology, Hospital Universitario La Princesa, Madrid, Spain
Carretero G:
Department of Dermatology, Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas de Gran Canaria, Spain
Ferrandiz C:
Department of Dermatology, Hospital Universitario Germans Trias i Pujol, Badalona, Spain
Vanaclocha F:
Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain
Gomez-Garcia FJ:
Department of Dermatology, Hospital Universitario Reina Sofía, Córdoba, Spain
Herrera-Ceballos E:
Department of Dermatology, Hospital Universitario Virgen de la Victoria, Málaga, Spain
De la Cueva-Dobao P:
Department of Dermatology, Hospital Infanta Leonor, Madrid, Spain
Belinchon I:
Department of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain
Sanchez-Carazo JL:
Department of Dermatology, Hospital General Universitario de Valencia, Valencia, Spain
Alsina M:
Department of Dermatology, Hospital Clínic de Barcelona, Barcelona, Spain
Lopez-Estebaranz JL:
Department of Dermatology, Hospital Universitario Fundacion Alcorcon, Madrid, Spain
Ferran M:
Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
Torrado R:
Department of Dermatology, Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas de Gran Canaria, Spain
Carrascosa JM:
Department of Dermatology, Hospital Universitario Germans Trias i Pujol, Badalona, Spain
Llamas M:
Department of Dermatology, Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas de Gran Canaria, Spain
Rivera R:
Department of Dermatology, Hospital Universitario Reina Sofía, Córdoba, Spain
Jimenez-Puya R:
Department of Dermatology, Hospital Universitario Virgen de la Victoria, Málaga, Spain
Garcia-Doval I:
Research Unit, Fundacion Academia Espanola de Dermatologia y Venereologia, Madrid, Spain
Department of Dermatology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
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