Adverse Medical Conditions Across Treatment Options in Patients With Psoriasis: A Claims-Based Analysis
J Drugs Dermatol
; 17(11): 1211-1218, 2018 11 01.
Article
em En
| MEDLINE
| ID: mdl-30500143
ABSTRACT
Objective:
To assess the real-world risk of developing adverse medical conditions (AMCs) among patients with psoriasis treated with biologic therapies or conventional systemic/topical therapies (CST/topical).Methods:
Adult patients with psoriasis were identified from the Truven MarketScan US claims database (2008 Q32015 Q3) and classified into cohorts based on treatment initiated on the index date (adalimumab [ADA], etanercept [ETN], ustekinumab [UST], infliximab [IFX], or CST/topical). Incident AMCs were identified while on treatment from diagnoses recorded in medical claims and included abnormal test results, infections, mental disorders, cardiovascular disease, malignancies (skin and non-skin), and respiratory disease. Cox proportional hazards models were used to compare AMC risk for (1) ADA, ETN, and UST (separately) vs CST/topical, and (2) ADA vs other biologic therapies (ETN, UST, and IFX combined). Regressions were adjusted for age, gender, region, insurance plan type, year, Charlson comorbidity index, and prior AMCs; and based on stepwise selection, comorbidities, specialist encounters, and frequently prescribed treatments.Results:
A total of 42,981 patients were identified (ADA 5,197; ETN 3,311; UST 1,370; IFX 187; CST/topical 32,916). Across cohorts, median age was 4650 years, 46.2%53.1% were female, and median follow-up duration was 3.37.9 months. For all cohorts, infection was the most frequent AMC (28.7%41.8%). Compared with CST/topical, ADA, ETN, and UST were associated with a lower risk of infections (adjusted hazard ratio [aHR] 0.93, 0.92, and 0.86, respectively, all P<0.05). ADA was associated with a lower risk of malignancies (aHR 0.71, P<0.05), and ETN was associated with a lower risk of respiratory disease (aHR 0.80, P<0.05). Compared with biologic therapies, ADA was not associated with higher risk of AMCs.Conclusions:
Compared to CST/topical, biologic therapies were associated with similar or lower risk of AMCs. Comparison between ADA and other biologic therapies suggests a similar safety profile with respect to the studied AMCs.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Vigilância de Produtos Comercializados
/
Psoríase
/
Produtos Biológicos
/
Antirreumáticos
/
Fármacos Dermatológicos
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Drugs Dermatol
Assunto da revista:
DERMATOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article