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Body mass index predicts discontinuation due to ineffectiveness and female sex predicts discontinuation due to side‐effects in patients with psoriasis treated with adalimumab, etanercept or ustekinumab in daily practice: a prospective, comparative, long‐term drug‐survival study from the Bio CAPTURE registry
Author(s) -
Zweegers J.,
Reek J.M.P.A.,
Kerkhof P.C.M.,
Otero M.E.,
Kuijpers A.L.A.,
Koetsier M.I.A.,
Arnold W.P.,
Berends M.A.M.,
WeppnerParren L.,
Ossenkoppele P.M.,
Njoo M.D.,
Mommers J.M.,
Lümig P.P.M.,
Driessen R.J.B.,
Kievit W.,
Jong E.M.G.J.
Publication year - 2016
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.14552
Subject(s) - ustekinumab , discontinuation , medicine , psoriasis , etanercept , adalimumab , body mass index , prospective cohort study , psoriasis area and severity index , physical therapy , dermatology , tumor necrosis factor alpha
Summary Background Predictors for successful treatment are important for personalized medicine. Predictors for drug survival of biologics in psoriasis have been assessed, but not split for different biologics or for the reason of discontinuation. Objectives To compare long‐term drug survival between the outpatient biologics adalimumab, etanercept and ustekinumab in patients with psoriasis, and to elucidate predictors for overall survival and drug discontinuation due to ineffectiveness and side‐effects for each biologic separately. Methods Ten years of data were extracted from the prospective, multicentre, long‐term Bio CAPTURE registry. Kaplan–Meier survival analyses and confounder‐corrected multivariate Cox regression analysis for drug survival ( MCR ‐ DS ) were performed to compare drug survival between biologics. To elucidate the predictors for different reasons of discontinuation for each biologic, univariate Cox regression analyses and multivariate Cox regression analyses for predictors ( MCR ‐P) with backward selection were performed. Results In total, 526 treatment episodes – 186 adalimumab, 238 etanercept and 102 ustekinumab – were included covering 1333 treatment years. MCR ‐ DS showed a significantly higher overall survival for ustekinumab compared with adalimumab and etanercept. MCR ‐P showed that higher body mass index ( BMI ) was a predictor for discontinuation due to ineffectiveness for etanercept and ustekinumab and that female sex was a predictor for discontinuation due to side‐effects for adalimumab, etanercept and ustekinumab. Conclusions Ustekinumab has the highest confounder‐corrected long‐term drug survival in psoriasis treatment, compared with adalimumab and etanercept. Higher BMI is a predictor for discontinuation due to ineffectiveness in etanercept and ustekinumab, and female sex is a consistent predictor for discontinuation due to side‐effects in all three outpatient biologics.