Biologic Drug Survival in Psoriasis: A Systematic Review & Comparative Meta-Analysis

Frontiers in Medicine

Ahmed I. Mourad¹  Robert Gniadecki³ 

[1] Dentistry, University of Alberta, Edmonton, AB, Canada;;Division of Dermatology, Department of Medicine, Faculty of Medicine &Division of Dermatology, Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, AB, Canada;

关键词: psoriasis;    drug survival;    biologics;    adalimumab;    ustekinumab;    etanercept;   

DOI  :  10.3389/fmed.2020.625755

来源: DOAJ

【 摘 要 】

Drug survival studies have been utilized to evaluate the real-world effectiveness of biologics used in psoriasis. However, the increasing volume of drug survival data suffers from large variability due to regional differences in drug availability, patient selection and biologic reimbursement. The objective of this study was to conduct a meta-analysis of biologic drug survival to determine comparative effectiveness of the biologics in a real-world setting. Studies reporting drug survival for biologic therapy in psoriasis were identified by a systematic literature search. Hazard ratio data for drug discontinuation were estimated directly from published Kaplan-Meier estimator curves at year 1, 2, and 5 of treatment and compared pairwise for the following biologics: ustekinumab, adalimumab, etanercept, infliximab, secukinumab, and ixekizumab. This pooled hazard ratios were used to estimate 2- and 5-year overall drug survival rates. Ustekinumab had the longest persistence at 2 and 5 years among all biologics included in this meta-analysis. Adalimumab was superior to etanercept and infliximab at 5 years. Pooled 5-year drug survival rates for adalimumab, etanercept, and infliximab were 46.3, 35.9, and 34.7%, respectively. Two- and five-year data were not available for anti-IL-17 drugs, but at 1-year ustekinumab outperformed secukinumab, the latter being equal to anti-TNFs. In conclusion, ustekinumab is characterized by longer drug survival than TNF inhibitors and IL-17 inhibitors. Estimated pooled 2- and 5-year drug survival rates may serve as a useful tool for patient communication and clinical decision-making.

【 授权许可】

Unknown