Oh Sohee, Choi Sungjun, Yoon Hyun-Sun
Department of Biostatistics, SMG-SNU Boramae Medical Center, Seoul, Korea.
Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea.
Ann Dermatol. 2022 Oct;34(5):321-330. doi: 10.5021/ad.22.003.
Factors other than efficacy and safety could influence the survival of biologics in patients with psoriasis. Little is known about whether different disease groups affect drug survival of biologics or not.
This study aimed to investigate whether the availability of alternative biologics and disease groups could influence drug survival of biologics approved for psoriasis and psoriasis arthritis (PsA).
A nationwide population-based retrospective cohort study was conducted using the Health Insurance and Review Assessment data in Korea between January 2009 and August 2019.
The drug survival analysis included 5,634 biologic episodes. Ustekinumab was the most frequently prescribed drug (n=2,488, 44.2%). Multivariable time-dependent Cox regression analysis showed that higher age, female sex, no comorbidity, concomitant cyclosporine or acitretin use, biologic-experienced and use of tumor necrosis factor (TNF)-α inhibitors were predictors of drug discontinuation. PsA was a predictor of drug persistence, particularly for TNF-α inhibitors. Ustekinumab and adalimumab discontinuation significantly increased after introducing secukinumab and ustekinumab, respectively.
The availability of alternative biologics and disease groups affect biologic drug survival in patients with psoriasis and PsA.
除疗效和安全性外，其他因素可能会影响银屑病患者生物制剂的留存率。对于不同疾病组是否会影响生物制剂的药物留存率，目前知之甚少。
本研究旨在调查替代生物制剂的可及性和疾病组是否会影响获批用于治疗银屑病和银屑病关节炎（PsA）的生物制剂的药物留存率。
利用韩国2009年1月至2019年8月的健康保险审查评估数据，开展了一项基于全国人群的回顾性队列研究。
药物留存率分析纳入了5634例生物制剂治疗疗程。乌司奴单抗是最常处方的药物（n = 2488，44.2%）。多变量时间依赖性Cox回归分析显示，年龄较大、女性、无合并症、同时使用环孢素或阿维A、有生物制剂使用经历以及使用肿瘤坏死因子（TNF）-α抑制剂是药物停用的预测因素。PsA是药物持续使用的预测因素，尤其是对于TNF-α抑制剂而言。分别引入司库奇尤单抗和乌司奴单抗后，乌司奴单抗和阿达木单抗的停用率显著增加。
替代生物制剂的可及性和疾病组会影响银屑病和PsA患者的生物制剂药物留存率。
