Academic Medical Center, Meibergdreef 9, Amsterdam, 1105AZ, the Netherlands.
Br J Dermatol. 2014 Oct;171(4):875-83. doi: 10.1111/bjd.13001. Epub 2014 Aug 21.
Drug survival depends on several factors such as dosing, effectiveness, quality-of-life improvement and safety, and could be seen as an overall marker for treatment success. Such data for biologics in psoriasis treatment are sparse.
To determine differences in drug survival between different biologics for psoriasis.
Drug survival, dosing, Psoriasis Area and Severity Index (PASI) and Skindex-29 at weeks 12 and 52, and adverse events of patients with psoriasis treated with a biologic registered in the local database of the Academic Medical Center, Amsterdam, were analysed. Patients were divided into those naive or non-naive for treatment episodes with biologics.
Drug survival did not differ significantly for naive treatment episodes between the biologics (etanercept 85% to 64%, adalimumab 77% to 77%, infliximab 75% to 75% for year 1-4), or for non-naive treatment episodes (etanercept 86% to 42%, adalimumab 84% to 56%, infliximab 68% to 43% for year 1-4; ustekinumab 84% to 57% for year 1-3). The naive group showed better drug survival and PASI 75 response at week 12, although the difference was not significant. A similar improvement of mean ∆PASI and mean ∆Skindex-29 was observed at weeks 12 and 52 for all biologics for both groups, although no significant difference was seen between groups. Treatment termination was due mainly to nonresponse for all biologics.
There was no significant difference in drug survival, mean ∆PASI or Skindex-29 response at weeks 12 or 52 between the biologics or between the naive and non-naive groups. Treatment termination was due mostly to nonresponse. Sequential treatment with the available biologics can be effective.
药物存活率取决于多种因素，如剂量、疗效、生活质量改善和安全性，并可作为治疗成功的整体指标。在银屑病治疗中，生物制剂的数据很少。
确定不同生物制剂治疗银屑病的药物存活率差异。
分析了在阿姆斯特丹学术医学中心的当地数据库中登记的接受生物制剂治疗的银屑病患者的药物存活率、剂量、银屑病面积和严重程度指数（PASI）和 Skindex-29 在第 12 周和第 52 周的情况，以及不良反应。患者分为生物制剂治疗初治和非初治组。
在生物制剂初治组中，药物存活率在不同药物之间无显著差异（依那西普为 85%至 64%，阿达木单抗为 77%至 77%，英夫利昔单抗为 75%至 75%，第 1-4 年），在非初治组中也是如此（依那西普为 86%至 42%，阿达木单抗为 84%至 56%，英夫利昔单抗为 68%至 43%，第 1-4 年；乌司奴单抗为 84%至 57%，第 1-3 年）。虽然差异无统计学意义，但初治组在第 12 周时药物存活率和 PASI75 反应更好。两组患者在第 12 周和第 52 周时，所有生物制剂的平均 ∆PASI 和平均 ∆Skindex-29 均有类似的改善，但组间无显著差异。所有生物制剂的治疗终止主要是由于无反应。
在药物存活率、第 12 周和第 52 周时的平均 ∆PASI 或 Skindex-29 反应方面，不同生物制剂之间或初治组和非初治组之间均无显著差异。治疗终止主要是由于无反应。现有生物制剂的序贯治疗可能是有效的。
