title: Drug survival of biologic therapy in a large, disease-based registry of patients with psoriasis: results from the Psoriasis Longitudinal Assessment and Registry (PSOLAR).
abstract: BACKGROUND
  Drug survival is a marker for treatment sustainability in chronic diseases such as psoriasis.
  
  
  OBJECTIVE
  The aim of these analyses was to assess survival of biologic treatments in the PSOriasis Longitudinal Assessment and Registry (PSOLAR).
  
  
  METHODS
  PSOLAR is a large, prospective, international, disease-based registry of patients with psoriasis receiving (or eligible for) systemic therapy in a real-world setting. Drug survival is defined as the time from initiation to discontinuation (stop/switch) of biologic therapy on registry. The number of patients who discontinued each treatment and the duration of therapy were recorded. Using Kaplan-Meier survival curves and Cox-regression analyses [hazard ratios (HR) and 95% confidence intervals (CIs)], time to discontinuation was compared across cohorts undergoing first-, second- or third-line treatment with ustekinumab, infliximab, adalimumab or etanercept.
  
  
  RESULTS
  As of the 2013 data cut, 12 095 patients with psoriasis were enrolled in PSOLAR. Of the 4000 patients initiating any new biologic therapy, approximately 3500 started a first-line, second-line or third-line biologic therapy during the registry. Lack of effectiveness was the most common reason for discontinuation across biologic therapies. Based on the multivariate analysis, significantly shorter times to discontinuation were observed for infliximab [HR (95%CI) = 2.73 (1.48-5.04), P = 0.0014]; adalimumab [4.16 (2.80-6.20), P < 0.0001]; and etanercept [4.91 (3.28-7.35) P < 0.0001] compared with ustekinumab [reference treatment]) for first-line biologic use; results were similar for treatment effects for second/third-line therapies. Although limited in power, analyses in patients with concurrent psoriatic arthritis confirmed by a rheumatologist reflect observations in the overall psoriasis population.
  
  
  CONCLUSIONS
  Drug survival was superior for ustekinumab compared with infliximab, adalimumab and etanercept in patients with psoriasis.
authors.affiliation: Baylor University Medical Center, Dallas, TX, USA.
authors.forename: A
authors.initials: A
authors.lastname: Menter
authors.affiliation: K Papp Clinical Research and Probity Medical Research, Inc., Waterloo, Ontario, Canada.
authors.forename: K A
authors.initials: KA
authors.lastname: Papp
authors.affiliation: SKIN Centre for Dermatology and Probity Medical Research, Peterborough, Ontario, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Gooderham
authors.affiliation: Eastern Virginia Medical School and Virginia Clinical Research, Norfolk, VA, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Pariser
authors.affiliation: University Medical Center, Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Augustin
authors.affiliation: Florida Academic Dermatology Centers, Miami, FL, USA.
authors.forename: F A
authors.initials: FA
authors.lastname: Kerdel
authors.affiliation: Janssen Scientific Affairs, LLC, Horsham, PA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Fakharzadeh
authors.affiliation: Janssen Scientific Affairs, LLC, Horsham, PA, USA.
authors.forename: K
authors.initials: K
authors.lastname: Goyal
authors.affiliation: Janssen Scientific Affairs, LLC, Horsham, PA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Calabro
authors.affiliation: Janssen Research & Development, LLC, Horsham, PA, USA.
authors.forename: W
authors.initials: W
authors.lastname: Langholff
authors.affiliation: Janssen Research & Development, LLC, Titusville, NJ, USA.
authors.forename: S
authors.initials: S
authors.lastname: Chavers
authors.affiliation: Janssen-Cilag NV, Beerse, Belgium.
authors.forename: D
authors.initials: D
authors.lastname: Naessens
authors.affiliation: Janssen-Cilag NV, Beerse, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Sermon
authors.affiliation: University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: G G
authors.initials: GG
authors.lastname: Krueger
mesh_terms: D000328:Adult; D001688:Biological Products / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy*; D012042:Registries
chemical_list: D001688:Biological Products; D003879:Dermatologic Agents