Improved effectiveness from individualized dosing of self-administered biologics for the treatment of moderate-to-severe psoriasis: a 5-year retrospective chart review from a Spanish University Hospital
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Other documents of the author: Sanz-Gil, Roser; Pellicer, Antonio; Montesinos, M. Carmen; Valcuende-Cavero, Francisca
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https://doi.org/10.1080/09546634.2019.1602246 |
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Title
Improved effectiveness from individualized dosing of self-administered biologics for the treatment of moderate-to-severe psoriasis: a 5-year retrospective chart review from a Spanish University HospitalDate
2019-04Publisher
Taylor & FrancisBibliographic citation
Roser Sanz-Gil, Antonio Pellicer, M. Carmen Montesinos & FranciscaValcuende-Cavero (2019): Improved effectiveness from individualized dosing of self-administeredbiologics for the treatment of moderate-to-severe psoriasis: a 5-year retrospective chartreview from a Spanish University Hospital, Journal of Dermatological Treatment, DOI:10.1080/09546634.2019.1602246Type
info:eu-repo/semantics/articlePublisher version
https://www.tandfonline.com/doi/full/10.1080/09546634.2019.1602246Version
info:eu-repo/semantics/publishedVersionSubject
Abstract
Background: Biologics for moderate-to-severe psoriasis are expensive and treatment substitutions may vastly increase cost. Moreover, administration regimens in routine practice may differ from recommended guidelines ... [+]
Background: Biologics for moderate-to-severe psoriasis are expensive and treatment substitutions may vastly increase cost. Moreover, administration regimens in routine practice may differ from recommended guidelines.
Objectives: To evaluate long-term effectiveness, regimen, drug-survival, and efficiency of self-administered biologics in clinical practice.
Methods: We performed a 5-year retrospective study in 72 patients (44 ± 14 years old) with moderate-to-severe psoriasis at the University Hospital La Plana (Vila-real, Spain), treated with subcutaneous biologics. We determined the effectiveness (PASI 75 or PASI < 5), and drug-survival using Kaplan-Meier estimates, and analyzed reasons for treatment interruption, drug substitution patterns, and costs.
Results: Etanercept was less effective (45%) than ustekinumab (85%) and adalimumab (71%). In 15% of patients, optimal responses were maintained despite dose intervals lengthening. Drug-survival was significantly lower for etanercept than for the other biologics (p < .005). Most adalimumab and etanercept discontinuations were due to adverse events or lack of effectiveness; for ustekinumab the causes were unrelated to drug effects. Ustekinumab was 100% effective as a secondary biologic.
Conclusion: Ustekinumab was the safest and most efficient treatment. Etanercept showed the highest treatment failure rate, incurring higher costs. Dosage individualization according to patient needs improves the therapy efficiency, reducing therapeutic failure and derived costs. [-]
Investigation project
University of Valencia (UV-INV-AE14-269136) ; Spanish Ministry formerly of Economy and Competitiveness and currently of Science, Innovation and Universities (SAF2017-85806-R)Rights
Copyright © 2019 Taylor & Francis Group, LLC.
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