Frequency and outcomes of treatment dose escalation with biologics in moderate-to-severe psoriasis: a Swedish register study
| Autor: | Axel Svedbom, Christina Wennerström, Fredrik Hjelm, Anna Tjärnlund, Mona Ståhle |
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| Jazyk: | angličtina |
| Rok vydání: | 2024 |
| Předmět: | |
| Zdroj: | Journal of Dermatological Treatment, Vol 35, Iss 1 (2024) |
| Druh dokumentu: | article |
| ISSN: | 09546634 1471-1753 0954-6634 76885097 |
| DOI: | 10.1080/09546634.2024.2398170 |
| Popis: | Background The advent of biosimilars may increase the frequency of dose escalation with biologics in psoriasis.Objective To explore the frequency and outcomes of dose escalation with adalimumab etanercept, and ustekinumab.Methods Data were extracted from DermaReg-Pso, a psoriasis register in Stockholm, Sweden. The main exposure was treatment, and the main outcome was dose escalation. We describe outcomes with dose escalation by estimating drug survival and changes in the Psoriasis Area and Severity Index (PASI).Results 554 patients had 946 treatment episodes with adalimumab, etanercept, or ustekinumab. The cumulative incidence of dose escalation was 4.1 per 100 treatment years. The Hazard Ratios (HRs) for dose escalation with ustekinumab vs adalimumab and ustekinumab vs etanercept were 1.93 (95% CI: 1.25-2.98), and 2.20 (95% CI: 1.42-3.41), respectively. After dose escalation, the HRs for treatment discontinuation with adalimumab and etanercept compared with ustekinumab were 3.10 (95% CI: 1.56-6.18) and 7.15 (95% CI: 3.96-12.94), respectively. PASI was higher after compared to before dose escalation for etanercept (p = 0.036), but not for adalimumab (p = 0.832) or ustekinumab (p = 0.300).Conclusions Dose escalation was comparatively more frequent with ustekinumab than with adalimumab or etanercept; however, treatment discontinuation after dose escalation was more common with adalimumab and etanercept than ustekinumab. |
| Databáze: | Directory of Open Access Journals |
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