Psoriasis: which risk factors predict discontinuation of biologic therapy?

  • Mourad A & al.
  • Br J Dermatol
  • 6 Feb 2019

  • curated by Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • A systematic review and meta-analysis suggest that female sex and obesity are associated with discontinuation of biologic drugs in patients with psoriasis.

Why this matters

  • Identification of risk factors can help optimize treatment planning.

Key results

  • Female sex (HR, 1.22; 95% CI,1.07-1.38) was associated with treatment discontinuation.
    • HR, 1.56; 95% CI, 1.24-1.97 in the etanercept (Enbrel) group.
    • HR, 1.53; 95% CI, 1.17-2.91 in the adalimumab (Humira) group.
  • Obesity (HR, 1.21; 95% CI, 1.10-1.32) was associated with treatment discontinuation.
    • HR, 1.21; 95% CI, 1.08-1.37 in the etanercept group.
    • HR, 1.43; 95% CI, 1.01-2.01 in the ustekinumab (Stelara) group.
  • Female sex was associated with discontinuation due to adverse events (HR, 2.16; 95% CI, 1.39-3.35).
    • HR, 3.16; 95% CI, 1.67-6.00 in the adalimumab group.
    • HR, 2.20; 95% CI, 1.29-3.75 in the etanercept group.
  • Concomitant psoriatic arthritis was associated with lower risk of treatment discontinuation (HR, 0.83; 95% CI, 0.80-0.86).

Study design

  • 13 studies including 29,802 patients were included.
    • 9 studies analyzed female sex (29,090 patients);
    • 6 studies analyzed obesity (9311 patients);
    • 6 studies analyzed psoriatic arthritis (24,444 patients).
  • Funding: None.

Limitations

  • Heterogeneity between included studies.

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