1. Effectiveness and clinical predictors of drug survival in psoriasis patients receiving apremilast: A registry analysis
- Author
-
Roland Lichem, Alexandra Gruber-Wackernagel, Paul-Gunther Sator, Werner Saxinger, Hannes Trattner, Igor Vujic, Nina Häring, Constanze Jonak, Martina Schütz-Bergmayr, Robert R. Müllegger, Gudrun Ratzinger, Franz J. Legat, Wolfgang Weger, Clemens Painsi, Wolfram Hoetzenecker, Claudia Kölli, Alexander Mlynek, Knut Prillinger, Adrian Tanew, Angelika Hofer, Hans Skvara, Wolfgang Salmhofer, Christina Ellersdorfer, Franz Quehenberger, Barbara Gruber, Erich Schmiedberger, Thomas Graier, and Peter Wolf
- Subjects
Drug ,medicine.medical_specialty ,PP, per protocol ,media_common.quotation_subject ,Arthritis ,apremilast ,Dermatology ,Intertriginous ,LOCF, last observation carried forward ,Psoriasis Area and Severity Index ,drug survival ,Internal medicine ,Psoriasis ,Medicine ,media_common ,business.industry ,Hazard ratio ,psoriasis ,medicine.disease ,HR, hazard ratio ,PASI, psoriasis area and severity index ,PsoRA, Psoriasis Registry Austria ,Concomitant ,Original Article ,Apremilast ,business ,SD, standard deviation ,medicine.drug - Abstract
Background Little is known about the effectiveness and drug survival associated with apremilast under real-world conditions. Objective To investigate the influence of patient and disease characteristics on drug survival associated with apremilast and to elucidate clinical effectiveness with regard to the psoriasis area and severity index (PASI) reduction. Methods This was an observational, retrospective, multicenter analysis from the Austrian Psoriasis Registry. Results Data from 367 patients were eligible for analysis. The 12-month drug survival rate associated with apremilast (ie, the proportion of patients on the drug) was 57.3% and decreased significantly in patients younger than 40 years (relative hazard ratio = 1.49, P = .007918). Sex; concomitant arthritis; previous biologic therapy; obesity; and palmoplantar, scalp, nail, and intertriginous involvement did not significantly affect drug survival. At 12 months, the response rates in patients receiving apremilast per protocol with a PASI of 50, 75, 90, and 100 were 80.0%, 56.4%, 38.2%, and 22.7%, respectively. Limitations Inclusion of a substantial number of patients with no record of absolute PASI at study entry and lack of PASI reduction follow-up data of 103 patients (28.1%) after starting apremilast treatment. Conclusion Apremilast is a robust antipsoriatic drug for which the drug survival is not strongly influenced by most patient- or disease-related factors except age. Drug survival is significantly shorter in patients younger than 40 years.
- Published
- 2020