Etanercept, adalimumab, and ustekinumab in psoriasis: analysis of 209 treatment series in Austria

• Published in: Journal der Deutschen Dermatologischen Gesellschaft 2017-03, Vol.15 (3), p.309-317
• Main Authors: Richter, Leo, Vujic, Igor, Sesti, Alma, Monshi, Babak, Sanlorenzo, Martina, Posch, Christian, Rappersberger, Klemens
• Format: Article
• Language: English
• Subjects: Adalimumab - administration & dosage; Adolescent; Adult; Age Distribution; Aged; Anti-Inflammatory Agents - administration & dosage; Austria - epidemiology; Child; Dermatologic Agents - administration & dosage; Etanercept - administration & dosage; Female; Humans; Immunosuppressive Agents - administration & dosage; Male; Middle Aged; Prescription drugs; Prevalence; Psoriasis; Psoriasis - drug therapy; Psoriasis - epidemiology; Retrospective Studies; Risk Factors; Sex Distribution; Treatment Outcome; Ustekinumab - administration & dosage; Young Adult
• ISSN: 1610-0379; 1610-0387
• DOI: 10.1111/ddg.13191

Summary Background and objectives Widely used in the treatment of psoriasis, biologics have been tested in numerous clinical trials. However, drug efficacies and adverse events (AEs) may differ in ‘real‐world’ patients as they do not undergo as rigorous selection and monitoring. Our objective was to examine drug survival, efficacy, and AEs (quality, time of onset) in ‘real‐world’ psoriasis patients treated with etanercept, adalimumab, and ustekinumab. Patients and methods Retrospective data analysis (Jan 1, 2004 to Jun 30, 2015) of patients treated at a psoriasis clinic in an Austrian hospital. All patients who had received at least one dose of etanercept, adalimumab, or ustekinumab were included in the analysis. We analyzed: demographics, drug survival, Psoriasis Area and Severity Index (PASI), as well as quality and time of onset of AEs. Results In 209 treatment series, the estimated median drug survival varied among the various treatments: 21 months (SE: 6.9) for etanercept, 61 months (SE: 9.4) for adalimumab, and 65 months (SE 1.4) for ustekinumab. Male gender and pretreatment with a biologic were positive predictors of longer drug survival in adalimumab. We found no significant difference in drug efficacy as determined by PASI. Conclusions Most AEs occur during the first year of treatment. Adalimumab and ustekinumab are marked by longer drug survival compared to etanercept.