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

J Dtsch Dermatol Ges. 2017 Mar;15(3):309-317. doi: 10.1111/ddg.13191. Epub 2017 Feb 27.

Abstract

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.

MeSH terms

  • 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
  • Prevalence
  • Psoriasis / drug therapy*
  • Psoriasis / epidemiology*
  • Retrospective Studies
  • Risk Factors
  • Sex Distribution
  • Treatment Outcome
  • Ustekinumab / administration & dosage*
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Dermatologic Agents
  • Immunosuppressive Agents
  • Ustekinumab
  • Adalimumab
  • Etanercept