RESUMO
INTRODUCTION: Plaque psoriasis is a common, often debilitating, chronic autoimmune inflammatory skin disease. Moderate-to-severe forms of psoriasis can be treated with biologics such as anti-interleukin and anti-tumor necrosis factor antibodies. We aimed to investigate treatment discontinuation among patients with psoriasis who initiated biologic treatment. METHODS: We conducted a retrospective, non-interventional cohort study based on anonymized claims data from the German statutory health insurance which covered the years from 2016 to 2021. We included adult patients with psoriasis who initiated biologic treatment in drug-specific cohorts. Over a 365-day follow-up period, we assessed the frequencies and the time until treatment discontinuation for different biologics. Differences in discontinuation rates were compared using a multivariate Cox proportional hazards model. RESULTS: A total of 2565 patients with psoriasis who initiated treatment with secukinumab (n = 612), adalimumab (n = 454), guselkumab (n = 354), ixekizumab (n = 259), ustekinumab (n = 241), tildrakizumab (n = 205), brodalumab (n = 166), risankizumab (n = 145), etanercept (n = 91), certolizumab (n = 29), and infliximab (n = 9) were included. A total of 1290 patients (50.29%) discontinued treatment during the follow-up period, ranging from 30.34% (risankizumab) to 69.23% (etanercept). Median time until discontinuation of treatment ranged from 102 days (etanercept) to 208 days (risankizumab). Once the biologic treatment was discontinued, 45.05% of patients restarted the treatment with the same agent, 23.10% of patients switched to another biologic, and 31.86% received no further biologic agent. Compared to patients treated with risankizumab, the treatment discontinuation rate was significantly higher (p < 0.05) in patients treated with the other biologics except ustekinumab (p = 0.12). CONCLUSIONS: Further research should explore reasons leading to treatment discontinuation in order to support treatment choices for patients with moderate-to-severe psoriasis.
RESUMO
DESIGN: /methodology/approach: This study conducts a systematic review to analyze the relationship between corporate governance and corporate sustainability. PURPOSE: As enterprises are directed through corporate governance, the integration of corporate sustainability is a necessary step to secure long-term firm success and react to recent social and environmental developments. Against this background, this paper investigates the following research question: Which internal corporate governance mechanisms drive corporate sustainability? FINDINGS: The results gained from a sample of 56 articles show findings for different internal corporate governance mechanisms such as board diversity, board independence, the board size, the board-level sustainability committee, the role of the CEO, ownership concentration, and the disclosure and transparency practice, which play a role in guiding a firm in a sustainable direction and achieving sustainability integration. The role of board diversity is discussed the most throughout the literature. PRACTICAL IMPLICATIONS: The results suggest that boards should be designed diversely and independently while having an appropriate size to work effectively. Furthermore, the sustainability strategies of CEOs should be motivated by incentives. Nevertheless, there has to be a consideration of the interrelations of the investigated mechanisms. SOCIAL IMPLICATIONS: The results suggest that being more transparent and showing non-financial performance at least compliant to sustainability regulations increases the orientation on stakeholder interests and long-term focus. ORIGINALITY/VALUE: The paper systemizes the research field related to internal corporate governance mechanisms and corporate sustainability to give an overview of the current research landscape and discuss the identified drivers. Overall, this research comprehensively sketches of what is known and unknown about the questions addressed in the systematic review.
