Cic edizioni internazionali
Clinical Dermatology

Retention rate of systemic drugs in patients with chronic plaque psoriasis

Original Article, 8 - 14
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Introduction. The retention rate (RR) is the proportion of patients who maintain the same drug in a given time period, and it is a tool for evaluating the effectiveness and safety of treatments.
Objective. Estimate the RR of systemic drugs in reallife patients with chronic plaque psoriasis.
Methods. Retrospective evaluation of 392 adult patients with psoriasis who received a systemic drug, including methotrexate (n=158), cyclosporine (n=35), acitretin (n=24), infliximab (n=61), etanercept (n=76) and adalimumab (n=38). RR was evaluated using the
Kaplan-Meier survival data analysis in which the event was drug discontinuation due to inefficacy or intolerance with log-rank tests. Cox proportional-hazards regression model was also estimated.
Results. The RR at 24 and 30 months (but not at 12 months) for TNF-α blockers was higher than methotrexate, cyclosporine and acitretin (p<0.001). Main cause of drug discontinuation was intolerance. No differences in RR were detected among TNF-α
blockers. In multivariate analysis the predictors of early drug discontinuation were having received any conventional drugs versus any TNF-α blockers, higher body mass index (HR 1.91, 95% C.I. 1.68-2.1; p=0.008) and having previously been treated with
more than three systemic drugs (HR 1.37, 95% C.I. 1.10-1.79; p=0.032).
Conclusions. RR of TNF-α blockers was higher than conventional drugs. Discontinuation of conventional drugs was mostly due to intolerance. RR of systemic drugs was negatively influenced by obesity and by history of previous drug failure.

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