title: ORBIT (Outcome and Retention Rate of Biologic Treatments for Psoriasis): A retrospective observational study on biologic drug survival in daily practice.
abstract: BACKGROUND
  Biologic drug survival in psoriasis reflects long-term performance in real-life settings. Previous studies have yielded inconsistent results.
  
  
  OBJECTIVE
  We sought to analyze long-term biologic survival and its associated variables in a large, real-life cohort of patients with moderate to severe chronic plaque psoriasis.
  
  
  METHODS
  This was an observational retrospective study. Data were extracted from clinical records of 427 patients treated with biologic agents over a 4-year period. Drug survival was analyzed using the Kaplan-Meier method and the influence of several covariates was assessed using Cox regression.
  
  
  RESULTS
  We analyzed 703 treatment courses. Overall median drug survival was 31.0 months. Cumulative probability of drug survival was lower in obese patients (23.0 months, 95% confidence interval 17.4-28.6) than in patients with body mass index less than 30 (37.3 months, 95% confidence interval 29.4-45.1, P = .001), and it was significantly higher for ustekinumab than for any other biologic agent (log rank test P < .001). Multivariate analysis showed that obesity, etanercept treatment, and strict adherence to approved doses were associated with an increased probability of drug withdrawal, whereas ustekinumab treatment, and PASI75 and PASI90 responses at week 16 prolonged drug survival.
  
  
  CONCLUSIONS
  Data were collected retrospectively.
  
  
  CONCLUSIONS
  These findings can facilitate the daily treatment of psoriatic patients and promote long-term effectiveness of biologic therapies.
authors.affiliation: Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Vilarrasa
authors.affiliation: Department of Dermatology, Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Notario
authors.affiliation: Department of Dermatology, Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Bordas
authors.affiliation: Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: López-Ferrer
authors.affiliation: Department of Clinical Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Ignasi J
authors.initials: IJ
authors.lastname: Gich
authors.affiliation: Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: llpuig@santpau.cat.
authors.forename: Lluís
authors.initials: L
authors.lastname: Puig
mesh_terms: D000068879:Adalimumab / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D001688:Biological Products / Q000008:administration & dosage / Q000494:pharmacology; D001691:Biological Therapy / Q000379:methods*; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000069285:Infliximab / Q000008:administration & dosage; D053208:Kaplan-Meier Estimate; D008297:Male; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011565:Psoriasis / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D013030:Spain; D013997:Time Factors; D000069549:Ustekinumab / Q000008:administration & dosage; D016903:Drug Monitoring
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products; D000069285:Infliximab; D000069549:Ustekinumab; D000068879:Adalimumab
keywords: adalimumab; biologics: cohort; efficacy; etanercept; infliximab; psoriasis; real-life; survival; treatment; ustekinumab