title: Efficacy and Survival of Systemic Psoriasis Treatments: An Analysis of the Swiss Registry SDNTT.
abstract: BACKGROUND
  The Swiss psoriasis registry SDNTT (Swiss Dermatology Network for Targeted Therapies) records the long-term safety and effectiveness of systemic treatment regimens for psoriasis.
  
  
  METHODS
  Patients with moderate to severe psoriasis are included in the SDNTT when treatment with a conventional systemic agent or biologic is initiated that was not previously used by the respective patient. Patients are followed over a 5-year period. Clinical data are obtained every 3-6 months using standardized case report forms. Here, baseline data and follow-up data for 1 year of patients included from October 2011 until December 2014 were analyzed.
  
  
  RESULTS
  Within 39 months, 323 patients from 7 tertiary dermatology centers in Switzerland were recruited in the SDNTT; 165 patients received biologics and 158 conventional systemic therapies. Patients treated with biologics had a significantly higher severity (PASI 11.3 vs. 9.2, BSA 15.6 vs.11.9, psoriatic arthritis 36.4 vs. 10.8%; p ≤ 0.005, p ≤ 0.013, p ≤ 0.001) and a longer duration of illness (19.2 vs. 14.4 years, p ≤ 0.003) compared to patients starting a conventional systemic treatment. PASI reduction was satisfying in both treatment groups, with 60.6% of patients treated with biologics achieving PASI75 after 1 year compared to 54.2% of patients receiving conventional systemic drugs (nonsignificant). On average, the drug survival in patients receiving a biologic therapy was significantly longer than those receiving conventional systemic treatments (30.5 vs. 19.2 months, p ≤ 0.001).
  
  
  CONCLUSIONS
  In the real-world setting of a prospective national therapy registry, the application of current therapeutic guidelines for patients with moderate to severe psoriasis resulted in a PASI reduction of approximately 70% within the first year of treatment, but current therapeutic targets of PASI75 and PASI90 were reached in only 58 and 36% of patients, respectively, at 1 year, highlighting a gap in efficacy between selective clinical trials and the real-world setting.
authors.affiliation: Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Julia-Tatjana
authors.initials: JT
authors.lastname: Maul
authors.forename: Vahid
authors.initials: V
authors.lastname: Djamei
authors.forename: Antonios G A
authors.initials: AGA
authors.lastname: Kolios
authors.forename: Barbara
authors.initials: B
authors.lastname: Meier
authors.forename: Justine
authors.initials: J
authors.lastname: Czernielewski
authors.forename: Pascal
authors.initials: P
authors.lastname: Jungo
authors.forename: Nikhil
authors.initials: N
authors.lastname: Yawalkar
authors.forename: Carlo
authors.initials: C
authors.lastname: Mainetti
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Laffitte
authors.forename: Christina
authors.initials: C
authors.lastname: Spehr
authors.forename: Mark
authors.initials: M
authors.lastname: Anliker
authors.forename: Markus
authors.initials: M
authors.lastname: Streit
authors.forename: Matthias
authors.initials: M
authors.lastname: Augustin
authors.forename: Stephan
authors.initials: S
authors.lastname: Rustenbach
authors.forename: Curdin
authors.initials: C
authors.lastname: Conrad
authors.forename: Jürg
authors.initials: J
authors.lastname: Hafner
authors.forename: Wolf-Henning
authors.initials: WH
authors.lastname: Boehncke
authors.forename: Luca
authors.initials: L
authors.lastname: Borradori
authors.forename: Michel
authors.initials: M
authors.lastname: Gilliet
authors.forename: Peter
authors.initials: P
authors.lastname: Itin
authors.forename: Lars E
authors.initials: LE
authors.lastname: French
authors.forename: Peter
authors.initials: P
authors.lastname: Häusermann
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Navarini
mesh_terms: D001688:Biological Products / Q000627:therapeutic use; D006801:Humans; D011565:Psoriasis / Q000188:drug therapy / Q000453:epidemiology* / Q000628:therapy*; D012042:Registries; D013557:Switzerland / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D001688:Biological Products
keywords: Biologics; Conventional systemic treatment; Psoriasis; Swiss psoriasis registry