Richter Leo, Vujic Igor, Sesti Alma, Monshi Babak, Sanlorenzo Martina, Posch Christian, Rappersberger Klemens
Rudolfstiftung Hospital, Department of Dermatology, Vienna, Austria.
School of Medicine, Sigmund Freud University Vienna, Austria.
J Dtsch Dermatol Ges. 2017 Mar;15(3):309-317. doi: 10.1111/ddg.13191. Epub 2017 Feb 27.
Widely used in the treatment of psoriasis, biologics have been tested in numerous clinical trials. However, drug efficacies and adverse events (AEs) may differ in 'real-world' patients as they do not undergo as rigorous selection and monitoring. Our objective was to examine drug survival, efficacy, and AEs (quality, time of onset) in 'real-world' psoriasis patients treated with etanercept, adalimumab, and ustekinumab.
Retrospective data analysis (Jan 1, 2004 to Jun 30, 2015) of patients treated at a psoriasis clinic in an Austrian hospital. All patients who had received at least one dose of etanercept, adalimumab, or ustekinumab were included in the analysis. We analyzed: demographics, drug survival, Psoriasis Area and Severity Index (PASI), as well as quality and time of onset of AEs.
In 209 treatment series, the estimated median drug survival varied among the various treatments: 21 months (SE: 6.9) for etanercept, 61 months (SE: 9.4) for adalimumab, and 65 months (SE 1.4) for ustekinumab. Male gender and pretreatment with a biologic were positive predictors of longer drug survival in adalimumab. We found no significant difference in drug efficacy as determined by PASI.
Most AEs occur during the first year of treatment. Adalimumab and ustekinumab are marked by longer drug survival compared to etanercept.
生物制剂广泛应用于银屑病治疗，已在众多临床试验中进行了测试。然而，“真实世界”的患者未经过同样严格的筛选和监测，药物疗效和不良事件（AE）可能有所不同。我们的目的是研究接受依那西普、阿达木单抗和乌司奴单抗治疗的“真实世界”银屑病患者的药物生存期、疗效及不良事件（质量、发生时间）。
对奥地利一家医院银屑病门诊治疗的患者进行回顾性数据分析（2004年1月1日至2015年6月30日）。分析纳入所有接受过至少一剂依那西普、阿达木单抗或乌司奴单抗的患者。我们分析了：人口统计学数据、药物生存期、银屑病面积和严重程度指数（PASI），以及不良事件的质量和发生时间。
在209个治疗系列中，不同治疗方法的估计药物生存期中位数各不相同：依那西普为21个月（标准误：6.9），阿达木单抗为61个月（标准误：9.4），乌司奴单抗为65个月（标准误1.4）。男性以及生物制剂预处理是阿达木单抗药物生存期更长的阳性预测因素。我们发现，由PASI确定的药物疗效无显著差异。
大多数不良事件发生在治疗的第一年。与依那西普相比，阿达木单抗和乌司奴单抗的药物生存期更长。
