title: Comorbidity as a predictor for drug survival of biologic therapy in patients with psoriasis.
abstract: BACKGROUND
  Psoriasis often requires lifelong therapy, and adherence to treatment is considered a marker for treatment success. Data on the drug survival of biologics in psoriasis patients with comorbidities are lacking.
  
  
  OBJECTIVE
  This study was designed to estimate the long-term drug survival rates of different biologic agents in a cohort of psoriasis patients and to evaluate reasons and predictors for treatment adherence.
  
  
  METHODS
  Drug survival rates and outcome parameters in psoriasis patients treated with biologic agents were analyzed.
  
  
  RESULTS
  A total of 125 treatment periods with adalimumab (n = 37), efalizumab (n = 9), etanercept (n = 55), infliximab (n = 13), and ustekinumab (n = 11) were administered to 67 psoriasis patients. Patients with psoriatic arthritis (P = 0.010) and without comorbidity (P = 0.033) demonstrated significantly greater rates of drug survival.
  
  
  CONCLUSIONS
  The overall efficacy of biologic agents is reduced with time. Patients with the comorbidity of metabolic syndrome demonstrate a loss of adherence to biologic treatment.
authors.affiliation: Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.|Department of Dermatology and Allergology, Philipps University Marburg, Marburg, Germany.
authors.forename: Arnd
authors.initials: A
authors.lastname: Jacobi
authors.affiliation: Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Stephan J
authors.initials: SJ
authors.lastname: Rustenbach
authors.affiliation: Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Augustin
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D015535:Arthritis, Psoriatic / Q000150:complications / Q000188:drug therapy; D015897:Comorbidity; D003879:Dermatologic Agents / Q000627:therapeutic use*; D057915:Drug Substitution; D000068800:Etanercept / Q000627:therapeutic use; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008297:Male; D055118:Medication Adherence; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D011565:Psoriasis / Q000150:complications* / Q000188:drug therapy*; D012189:Retrospective Studies; D000069549:Ustekinumab / Q000627:therapeutic use
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D003879:Dermatologic Agents; D000069285:Infliximab; D000069549:Ustekinumab; D000068879:Adalimumab; D000068800:Etanercept; C472181:efalizumab