Switching Biologics in the Treatment of Psoriasis: A Multicenter Experience.
Dermatology
; 237(1): 22-30, 2021.
Article
em En
| MEDLINE
| ID: mdl-31865339
ABSTRACT
BACKGROUND/OBJECTIVE:
The purpose of our study was to provide evidence on the treatment choices, reasons, and results of switching between biologic agents in treating patients with psoriasis.METHODS:
We conducted a retrospective database search of six tertiary referral centers for pso-riasis patients between January 2007 and May 2019. We analyzed patient and treatment characteristics of all patients in the registry.RESULTS:
We enrolled 427 psoriatic patients treated with biologics, and 145 (34%) required a switch to another biologic. The reasons for discontinuing the first biologic agent were inefficacy (n = 106, 62.4%), adverse events (n = 28, 16.5%), and others (n = 36, 21.2%). At week 12, there was a 67.7% reduction in the Psoriasis Area and Severity Index (PASI) score of patients treated with their first biologic, and 51.4% reduction for the second. A drug survival analysis showed no statistically significant difference between the drug survival of first-line biologic agents, but ustekinumab had the highest survival rate among second-line biologics (log-rank p = 0.010). Multivariate analyses for overall drug discontinuation showed that the occurrence of psoriatic arthritis (OR 1.883, 95% CI 1.274-2.782, p = 0.001), nail involvement (OR 2.334, 95% CI 1.534-3.552, p < 0.001), and use of concomitant treatment (OR 2.303, 95% CI 1.403 -3.780, p = 0.001) are predictors for discontinuation.CONCLUSION:
Discontinuation of treatment was most commonly due to inefficacy. Patients who switched to a different biologic agent showed a similar improvement in PASI scores compared to biologic-naive patients. Switching to a second biologic therapy due to inefficacy or adverse events caused by the first one may improve psoriasis.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Psoríase
/
Produtos Biológicos
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Fármacos Dermatológicos
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article