title: Factors associated with drug survival of methotrexate and acitretin in patients with psoriasis.
abstract: Drug survival has recently become an important clinical issue in psoriasis. However, there has been little research into factors associated with drug survival of methotrexate and acitretin. The aim of this study was to investigate factors associated with drug survival of methotrexate and acitretin treatment for psoriasis. Survival analysis was performed in patients who received methotrexate or acitretin for the treatment of psoriasis, drawn from the Clalit Health Services database. Investigated factors included demographic variables, obesity, metabolic syndrome, psoriatic arthritis, administration route and folic acid supplementation. Among 6,256 patients, factors associated with treatment drop-out were: younger age (p <0.001) and psoriatic arthritis (acitretin p < 0.001). For methotrexate, metabolic syndrome (p = 0.033), intramuscular administration route of injection (p <0.001) and lack of folic acid supplementation (p <0.001) were associated with treatment drop-out. In patients with psoriasis, some ancillary factors may modify the drug survival of acitretin and methotrexate.
authors.affiliation: Department of Dermatology and Venereology, Soroka Medical Center, P.O.B. 151, 84101 Beer-Sheva, Israel. Guyshallom1234@hotmail.com.
authors.forename: Guy
authors.initials: G
authors.lastname: Shalom
authors.forename: Devy
authors.initials: D
authors.lastname: Zisman
authors.forename: Ilana
authors.initials: I
authors.lastname: Harman-Boehm
authors.forename: Haim
authors.initials: H
authors.lastname: Biterman
authors.forename: Sari
authors.initials: S
authors.lastname: Greenberg-Dotan
authors.forename: Ilya
authors.initials: I
authors.lastname: Polishchuk
authors.forename: Hadas
authors.initials: H
authors.lastname: Moser
authors.forename: Tamar
authors.initials: T
authors.lastname: Freud
authors.forename: Ilan
authors.initials: I
authors.lastname: Feldhamer
authors.forename: Arnon D
authors.initials: AD
authors.lastname: Cohen
mesh_terms: D017255:Acitretin / Q000008:administration & dosage / Q000627:therapeutic use*; D000284:Administration, Oral; D000328:Adult; D000367:Age Factors; D000368:Aged; D015535:Arthritis, Psoriatic / Q000150:complications; D016208:Databases, Factual; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D006801:Humans; D007557:Israel; D053208:Kaplan-Meier Estimate; D007641:Keratolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D055118:Medication Adherence; D024821:Metabolic Syndrome / Q000150:complications; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy*
chemical_list: D003879:Dermatologic Agents; D007641:Keratolytic Agents; D005492:Folic Acid; D017255:Acitretin; D008727:Methotrexate