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Thursday, September 14th, 2017
Table of Contents

1 Introduction
5 PMID
 [F] Diseases Research  / PubMed Research Articles  /
Biologics combined with conventional systemic agents or phototherapy for the treatment of psoriasis: real-life data from PSONET registries.

PubMed

 

Resource

Journal of the European Academy of Dermatology and Venereology : JEADV 2017 Sep 12; ()

Authors

Busard CI1; Cohen AD2; Wolf P3; Gkalpakiotis S4; Cazzaniga S5; Stern RS6; Hutten BA7; Feldhamer I8; Quehenberger F9; Lichem R10; Kojanova M11; Adenubiova E12; Addis A13; Naldi L14; Spuls PI15;

Author Information
  • 1Department of Dermatology, Academic Medical Center, University of Amsterdam, the Netherlands.
  • 2Clalit Health Services, Department of Quality measurements and research, Tel-Aviv, Israel.
  • 3Department of Dermatology, Medical University of Graz, Graz, Austria.
  • 4Department of Dermatovenereology, Third Faculty of Medicine, Charles University and University Hospital of Kralovske Vinohrady, Prague, Czech Republic.
  • 5Centro Studi GISED, Fondazione per la Ricerca, Ospedale Maggiore, Bergamo, Italy.
  • 6Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass, USA.
  • 7Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam.
  • 8Clalit Health Services, Department of Quality measurements and research, Tel-Aviv, Israel.
  • 9Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria.
  • 10Department of Dermatology, Medical University of Graz, Graz, Austria.
  • 11Department of Dermatovenereology, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic.
  • 12Department of Dermatovenereology, Third Faculty of Medicine, Charles University and University Hospital of Kralovske Vinohrady, Prague, Czech Republic.
  • 13Department of Epidemiology, Servizio Sanitario Regionale, Regione Lazio, Italy.
  • 14Centro Studi GISED, Fondazione per la Ricerca, Ospedale Maggiore, Bergamo, Italy.
  • 15Department of Dermatology, Academic Medical Center, University of Amsterdam, the Netherlands.

Abstract

BACKGROUND: Biologics have greatly improved psoriasis management. However, primary and secondary non-response to treatment requires innovative strategies to optimize outcomes.

OBJECTIVE: To describe the use of combined treatment of biologics with conventional systemic agents or phototherapy in daily clinical practice.

METHODS: We collected data on frequency of use, demographics, treatment characteristics and drug survival of biologics combined with conventional systemic agents or phototherapy in five PSONET registries.

RESULTS: Of 9922 biologic treatment cycles, 982 (9.9%) were identified as combination treatment. 72.9% of treatment cycles concerned concomitant use of methotrexate, 25.3% concerned concomitant UVB therapy, acitretin or cyclosporin and 1.8% concerned combined treatment with PUVA, fumaric acids or a second biologic. Substantial variation was detected in type and frequency of combination treatments prescribed across registries. Patients initiated on combined treatment had generally severe disease and were affected with psoriasis for many years. The extent to which patients had been priory treated with biologic monotherapy and the proportion of patients affected with psoriatic arthritis differed between registries. Survival rates for etanercept, adalimumab, infliximab and ustekinumab with methotrexate ranged between 43-92%, 28-83%, 65-87% and 53-77% respectively across registries after one year with no consistent superior survival for a particular biologic. Longest survival on a biologic combined with methotrexate, acitretin or cyclosporin was 103, 78 and 34 months respectively.

CONCLUSION: Methotrexate was the most commonly used concomitant treatment for patients on a biologic. Wide geographical variations in treatment selection and persistence of combination treatment exist. Data derived from ongoing studies may help to determine whether combined treatment is superior to biologic monotherapy. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

PMID

28898541

Others

Publication Type: Journal Article


This article is licensed under the the National Library of Medicine License. It uses material from the PubMed National Library of Medicine Data.


Last Modified:   2016-03-27


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