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

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 ob...

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Autores principales: Mourad, Ahmed I., Gniadecki, Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8012481/
https://www.ncbi.nlm.nih.gov/pubmed/33816514
http://dx.doi.org/10.3389/fmed.2020.625755
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author Mourad, Ahmed I.
Gniadecki, Robert
author_facet Mourad, Ahmed I.
Gniadecki, Robert
author_sort Mourad, Ahmed I.
collection PubMed
description 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.
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spelling pubmed-80124812021-04-02 Biologic Drug Survival in Psoriasis: A Systematic Review & Comparative Meta-Analysis Mourad, Ahmed I. Gniadecki, Robert Front Med (Lausanne) Medicine 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. Frontiers Media S.A. 2021-03-18 /pmc/articles/PMC8012481/ /pubmed/33816514 http://dx.doi.org/10.3389/fmed.2020.625755 Text en Copyright © 2021 Mourad and Gniadecki. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Mourad, Ahmed I.
Gniadecki, Robert
Biologic Drug Survival in Psoriasis: A Systematic Review & Comparative Meta-Analysis
title Biologic Drug Survival in Psoriasis: A Systematic Review & Comparative Meta-Analysis
title_full Biologic Drug Survival in Psoriasis: A Systematic Review & Comparative Meta-Analysis
title_fullStr Biologic Drug Survival in Psoriasis: A Systematic Review & Comparative Meta-Analysis
title_full_unstemmed Biologic Drug Survival in Psoriasis: A Systematic Review & Comparative Meta-Analysis
title_short Biologic Drug Survival in Psoriasis: A Systematic Review & Comparative Meta-Analysis
title_sort biologic drug survival in psoriasis: a systematic review & comparative meta-analysis
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8012481/
https://www.ncbi.nlm.nih.gov/pubmed/33816514
http://dx.doi.org/10.3389/fmed.2020.625755
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