特应性皮炎患者的药物生存率和停药原因：一项成人门诊患者的回顾性研究。
Drug survival rates and reasons for drug discontinuation in patients with atopic dermatitis: a retrospective study of adult outpatients.
机构信息
Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany, Department of Dermatology and Allergology Helios Dr. Horst Schmidt Clinics, Wiesbaden, Germany.
Department of Dermatology, Venereology, and Allergology, University Medical Center Göttingen, Göttingen, Germany.
出版信息
Eur J Dermatol. 2021 Apr 1;31(2):233-238. doi: 10.1684/ejd.2021.4020.
BACKGROUND
Treatment of moderate-to-severe atopic dermatitis (AD) can be challenging and little is known about the sustainability of on- and off-label prescribed systemic therapies.
OBJECTIVES
To compare drug survival (DS) rates and reasons for drug discontinuation of cyclosporine A (CyA), dupilumab (DUP), azathioprine (AZA), methotrexate (MTX) and mycophenolate mofetil (MMF) prescribed under real-world conditions.
MATERIALS & METHODS: In this retrospective study, 139 treatment courses for 94 adults with AD treated at two German dermatology departments were analysed.
RESULTS
Based on Cox regressions with CyA as reference category, hazard ratios for treatment discontinuation were 0.10 for DUP, 0.87 for MTX, 0.98 for MMF, and 1.18 for AZA. CyA, AZA, and MTX were most frequently interrupted due to adverse events, and MMF due to non-compliance. Only one patient (6.3%) discontinued DUP before the end of the observation period, which was due to ineffectiveness.
CONCLUSION
Systemic therapies for AD differ with regards to DS and reasons leading to treatment withdrawal; this should be considered in real-life practice.
背景
中重度特应性皮炎（AD）的治疗具有挑战性，对于处方的系统治疗药物的持续使用情况知之甚少。
目的
比较环孢素 A（CyA）、度普利尤单抗（DUP）、阿扎胞苷（AZA）、甲氨蝶呤（MTX）和吗替麦考酚酯（MMF）在真实环境下的药物生存（DS）率和停药原因。
材料与方法
在这项回顾性研究中，分析了在德国两家皮肤科诊所接受治疗的 94 名成人患者的 139 例治疗疗程。
结果
基于以 CyA 为参考类别的 Cox 回归，治疗中断的风险比分别为 DUP 0.10、MTX 0.87、MMF 0.98 和 AZA 1.18。CyA、AZA 和 MTX 最常因不良反应而中断，而 MMF 则因不遵守治疗方案而中断。只有 1 名患者（6.3%）因无效而在观察期结束前停用了 DUP。
结论
AD 的系统治疗药物在 DS 和导致停药的原因方面存在差异；在实际治疗中应考虑到这些差异。
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