RESUMO
OBJECTIVE: While biologics have been used for the patients with psoriatic arthritis, there remains to be unknown concerning long-term retention rates. This study aims to present real-world data about long-term retention rates of biologics for the patients with psoriatic arthritis, and to undertake an analysis of the contributing factors. METHODS: We examined retention rates and the reasons for discontinuation for biologics (adalimumab, certolizumab pegol, secukinumab, and ixekizumab) in 146 prescriptions (of which, 109 prescriptions were as naive) at our hospital since March 2010. RESULTS: Throughout the entire course of the study, the 10-year retention rates were approximately 70% for adalimumab, 50% for ixekizumab, and 40% for secukinumab. When evaluating retention rates in the biologic-naïve subgroups, the 10-year retention rates were all approximately 70%. Regarding certolizumab pegol, the 3-year retention rate was approximately 75%. For adalimumab, a higher degree of arthritis at the initiation of treatment was found to correlate with an increased likelihood of secondary inefficacy. The main reason for discontinuation was secondary inefficacy, except for ixekizumab. CONCLUSIONS: Each biologic exhibited a favourable long-term retention rate. The main reason for discontinuation was secondary inefficacy. Regarding adalimumab, secondary inefficacy was linked to the extent of arthritis upon treatment initiation.
Assuntos
Anticorpos Monoclonais Humanizados , Antirreumáticos , Artrite Psoriásica , Interleucina-17 , Humanos , Artrite Psoriásica/tratamento farmacológico , Artrite Psoriásica/imunologia , Masculino , Feminino , Pessoa de Meia-Idade , Interleucina-17/antagonistas & inibidores , Interleucina-17/imunologia , Anticorpos Monoclonais Humanizados/uso terapêutico , Adulto , Antirreumáticos/uso terapêutico , Adalimumab/uso terapêutico , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Certolizumab Pegol/uso terapêutico , Idoso , Produtos Biológicos/uso terapêutico , Resultado do TratamentoAssuntos
Transplante de Células-Tronco Hematopoéticas , Penfigoide Bolhoso , Dermatoses do Couro Cabeludo , Humanos , Penfigoide Bolhoso/diagnóstico , Penfigoide Bolhoso/tratamento farmacológico , Penfigoide Bolhoso/etiologia , Couro Cabeludo , Dermatoses do Couro Cabeludo/diagnóstico , Dermatoses do Couro Cabeludo/etiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversosAssuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Antineoplásicos Imunológicos/efeitos adversos , Dermatomiosite/etiologia , Neoplasias Pulmonares/tratamento farmacológico , Síndromes Paraneoplásicas/etiologia , Idoso , Dermatomiosite/diagnóstico , Dermatomiosite/patologia , Humanos , Neoplasias Pulmonares/complicações , Imageamento por Ressonância Magnética , Masculino , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/patologia , Síndromes Paraneoplásicas/diagnóstico , Síndromes Paraneoplásicas/patologia , Pele/diagnóstico por imagem , Pele/patologiaRESUMO
Cutaneous adverse events caused by aromatase inhibitors have been reported to be rare. We describe a rare case of a cutaneous adverse event that developed in a cancer-affected breast after aromatase inhibitor treatment. A 72-year-old postmenopausal female patient who was diagnosed with stage IA breast cancer received anastrozole as adjuvant treatment. Six months after the initiation of anastrozole, she developed an irregularly shaped purpuric plaque with several purpuric papules surrounding the postoperative scar on her left breast. Histological findings revealed capillary vessel proliferation and expansion, with hemorrhage in the superficial dermis. Immunohistochemistry of the skin biopsy specimen revealed hormone receptor expression limited to the vascular endothelial cells of the proliferating and expanding vessels. We believe that anastrozole induced a change in the local estrogen level, which affected the hormone receptor-positive endothelial cells in the dermis near the primary lesion of the breast cancer and caused a cutaneous adverse event only in the aforementioned area.