title: Comparison of the 1- and 5-year effectiveness of adalimumab, etanercept and ustekinumab in patients with psoriasis in daily clinical practice: results from the prospective BioCAPTURE registry.
abstract: BACKGROUND
  The efficacy of etanercept and ustekinumab in psoriasis has been compared in one randomized controlled trial. Comparison of the long-term effectiveness of biologics in daily-practice psoriasis treatment is currently lacking.
  
  
  OBJECTIVE
  To compare the effectiveness between the three widely used outpatient biologics adalimumab, etanercept and ustekinumab in daily-practice psoriasis treatment and to correct for confounders.
  
  
  METHODS
  Data were extracted from the prospective, multicentre BioCAPTURE registry. Multilevel linear regression analyses (MLRAs) and generalized estimating equation (GEE) analyses were performed on the course of mean Psoriasis Area and Severity Index (PASI) and PASI 75 (≥ 75% reduction vs. baseline). Both models were corrected for confounders. Subgroup analyses for biological dose were performed.
  
  
  RESULTS
  We included 356 patients with 513 treatment episodes: 178 adalimumab, 245 etanercept and 90 ustekinumab. MLRA showed a similar effectiveness between adalimumab, etanercept and ustekinumab after 1 year, but the highest effectiveness for ustekinumab during 5 years of treatment (P = 0·047; ustekinumab vs. etanercept, P = 0·019). GEE analysis revealed a higher chance of attaining PASI 75 with adalimumab and ustekinumab than with etanercept at 1 year of treatment. A higher than label dose was more often used in patients treated with etanercept (adalimumab, etanercept and ustekinumab: respectively 31·5%, 55·1% and 17% after 1 year, P < 0·001; 39·3%, 71·4% and 24% after 5 years, P < 0·001).
  
  
  CONCLUSIONS
  Compared with etanercept, ustekinumab had the highest effectiveness during 5 years of treatment. Patients receiving adalimumab and ustekinumab more often reached PASI 75 than those on etanercept at 1 year of treatment. Dose escalation was more frequent in etanercept and adalimumab than in ustekinumab.
authors: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors: J
authors: J
authors: Zweegers
authors: Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.
authors: J M M
authors: JMM
authors: Groenewoud
authors: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors: J M P A
authors: JMPA
authors: van den Reek
authors: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors: M E
authors: ME
authors: Otero
authors: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors: P C M
authors: PCM
authors: van de Kerkhof
authors: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors: R J B
authors: RJB
authors: Driessen
authors: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors: P P M
authors: PPM
authors: van Lümig
authors: Department of Dermatology, Ziekenhuisgroep Twente, Almelo/Hengelo, the Netherlands.
authors: M D
authors: MD
authors: Njoo
authors: Department of Dermatology, Ziekenhuisgroep Twente, Almelo/Hengelo, the Netherlands.
authors: P M
authors: PM
authors: Ossenkoppele
authors: Department of Dermatology, St Anna Ziekenhuis, Geldrop, the Netherlands.
authors: J M
authors: JM
authors: Mommers
authors: Department of Dermatology, Gelre Ziekenhuizen, Apeldoorn, the Netherlands.
authors: M I A
authors: MIA
authors: Koetsier
authors: Department of Dermatology, Ziekenhuis Gelderse Vallei, Ede, the Netherlands.
authors: W P
authors: WP
authors: Arnold
authors: Department of Dermatology, Jeroen Bosch Ziekenhuis, Den Bosch, the Netherlands.
authors: M P M
authors: MPM
authors: Andriessen
authors: Department of Dermatology, Maxima Medisch Centrum, Eindhoven/Veldhoven, the Netherlands.
authors: A L A
authors: ALA
authors: Kuijpers
authors: Department of Dermatology, Slingeland Ziekenhuis, Doetinchem, the Netherlands.
authors: M A M
authors: MAM
authors: Berends
authors: Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.
authors: W
authors: W
authors: Kievit
authors: Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors: E M G J
authors: EMGJ
authors: de Jong
mesh_terms: D000068879:Adalimumab / Q000008:administration & dosage*; D003879:Dermatologic Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D000068800:Etanercept / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy*; D012042:Registries; D012720:Severity of Illness Index; D016896:Treatment Outcome; D000069549:Ustekinumab / Q000008:administration & dosage*
chemical_list: D003879:Dermatologic Agents; D000069549:Ustekinumab; D000068879:Adalimumab; D000068800:Etanercept