Biologics combined with conventional systemic agents or phototherapy for the treatment of psoriasis: real‐life data from PSONET registries

Busard, C.; Cohen, Avner H.; Wolf, Peter; Gkalpakiotis, Spyridon; Cazzaniga, Simone; Stern, Robert S.; Hutten, Barbara A.; Feldhamer, Ilan; Quehenberger, Franz; Lichem, R.; Kojanová, Martina; Adenubiova, E; Addis, Antonio; Naldi, Luigi; Spuls, Phyllis I.

doi:10.1111/jdv.14583

Cited by 32 publications

(37 citation statements)

References 39 publications

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“…Confounding by indication was possible; disease severity was generally mild in all cohorts and was within the same range across existing and initiated therapy, but some differences were seen for prior csDMARD use. Previous registry studies provided similar results but were conducted either outside the United States [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] or they used a subset of PsA patients from a registry in the United States that was designed primarily for patients with rheumatoid arthritis [40][41][42][43]. Our study used data from a registry in the United States that was specifically designed to collect information about patients with PsA.…”

Section: Discussionmentioning

confidence: 95%

“…Patient and physician global disease assessments are combined with 28 swollen and tender joint counts to calculate the Clinical Disease Activity Index (CDAI) from 0 to 76, where < 2.9 is remission, 2.9-10.0 low disease activity, 10.1-22.0 moderate disease activity, and > 22.0 high disease activity [14]. Disease Activity in Psoriatic Arthritis (DAPSA) scores are calculated from joint counts (68 tender/66 swollen), CRP, and patient assessments of disease activity and pain, yielding scores consistent with remission (0-4) or mild (5)(6)(7)(8)(9)(10)(11)(12)(13)(14), moderate (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28), or high (> 28) disease activity [15]. Patients use the Work Productivity and Activity Impairment questionnaire to report the effect of PsA/SpA on work (percentage of hours missed, impairment while at work, and work hours affected) and daily activities [16][17][18].…”

Section: Data Collectionmentioning

confidence: 99%

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Persistence of tumor necrosis factor inhibitor or conventional synthetic disease-modifying antirheumatic drug monotherapy or combination therapy in psoriatic arthritis in a real-world setting

Mease

Accortt

Rebello³

et al. 2019

Rheumatol Int

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This study described treatment patterns in a psoriatic arthritis (PsA) patient registry for new or ongoing tumor necrosis factor inhibitor (TNFi) monotherapy, conventional synthetic disease-modifying antirheumatic drug (csDMARD) monotherapy, or TNFi/csDMARD combination therapy. This retrospective analysis included adults with PsA who enrolled in the Corrona PsA/ spondyloarthritis registry between March 21, 2013 (registry initiation), and January 31, 2017, and received an approved TNFi and/or csDMARD as "existing use" starting before registry entry or "initiated use" starting on/after registry entry. Therapy persistence was defined as index therapy use for ≥ 12 months without a treatment gap of ≥ 30 days. Among the evaluable patients with existing TNFi monotherapy (n = 251), csDMARD monotherapy (n = 225), and combination therapy (n = 214), 93, 87, and 87% were persistent for ≥ 12 months, and another 6, 5, and 5%, respectively, had no change with < 12 months of follow-up after first use. Among evaluable patients who initiated use of TNFi monotherapy (n = 26), csDMARD monotherapy (n = 35), and combination therapy (n = 15), 50, 43, and 53% were persistent for ≥ 12 months, and another 27, 20, and 20%, respectively, had no change with < 12 months of follow-up after first use. After initiation of index therapy, most changes (19-27% of patients) were discontinuation; 4-13% switched biologic therapy during follow-up. The results of this analysis of real-world treatment patterns in a PsA patient registry suggest that nonpersistence for TNFi monotherapy, csDMARD monotherapy, or TNFi/csDMARD combination therapy occurs more commonly after initiation of therapy than in patients with existing therapy. Trial registration: NCT02530268.

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Section: Discussionmentioning

confidence: 95%

Section: Data Collectionmentioning

confidence: 99%

Persistence of tumor necrosis factor inhibitor or conventional synthetic disease-modifying antirheumatic drug monotherapy or combination therapy in psoriatic arthritis in a real-world setting

Mease

Accortt

Rebello³

et al. 2019

Rheumatol Int

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“…This result is slightly different from what is reported in previous studies. Busard et al 6 investigated the conventional systemic agents or phototherapy combined with biologics and found that methotrexate was most frequently used compound. However, this study only ana-lyzed the concomitant combined treatment during the use of biologics, whereas we investigated the combined treatment with etanercept and the rotational treatment between intermittent etanercept treatments.…”

Section: Discussionmentioning

confidence: 99%

Real-World Experience with Etanercept Therapy and the Switching Pattern among Korean Patients with Psoriasis after Withdrawal of Etanercept

Choi

Kim

et al. 2019

Ann Dermatol

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Background: The efficacy and safety of etanercept in the treatment of psoriasis has been proven, and the drug was approved for the treatment of moderate to severe psoriasis. However, there have been few studies that have presented real-world data focused on concomitant treatment during etanercept treatment, and the switching pattern after discontinuation of etanercept. Objective: To reveal the real-world treatment pattern of etanercept-based psoriasis treatment and to investigate the switching pattern after withdrawal of etanercept. Methods: We enrolled 66 patients with psoriasis who were treated with etanercept. We collected data regarding the demographic characteristics of the patients, etanercept treatment schedules, and other treatments administered during the etanercept treatment period. We also investigated the treatment pattern after the discontinuation of etanercept with emphasis on the drug-free interval and the administered treatment modalities. Results: The mean treatment duration was 22.7±26.1 months and the mean number of etanercept injections was 21.5±27.9. Thirty-six patients were administered concomitant systemic medication or phototherapy. After discontinuation of etanercept, 54 patients were followed up and 34 of these patients were administered other systemic medication or phototherapy; phototherapy and cyclosporine was the most commonly administered treatment modality and 27.4% of treatments used biologics. Conclusion: The treatment schedule for etanercept was modified according to the severity of psoriasis and concomitant treatment was administered to improve the effectiveness of treatment in the patients enrolled in the study. We also found that most patients required other treatment modalities to control psoriasis during the period of etanercept treatment. (Ann Dermatol 31(1) 44∼50, 2019

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“…Traditionally, various topical therapies can be used to treat the patients with mild disease of psoriasis, such as topical retinoids, corticosteroids, vitamin D and its analogues . And the combination treatment of topical agents and other adjuvant therapies was the major therapeutic strategy for the severe psoriasis patients; however, its effects are very limited …”

Section: Discussionmentioning

confidence: 99%

Rapamycin ameliorates psoriasis by regulating the expression and methylation levels of tropomyosin viaERK1/2 andmTORpathways in vitro and in vivo

Gao

2018

Experimental Dermatology

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Psoriasis is a chronic inflammatory disease, affecting more than millions of people in the world. Recently, the mTOR inhibitor rapamycin (RAPA) was reported to be involved in the pathogenesis of psoriasis. However, the underlying mechanism remains unclear. Haematoxylin and eosin staining was used to examine the effects of RAPA on inflammatory level of lesional tissues from patients with psoriasis and animal models. Quantitative real-time PCR, immunohistochemistry and western blot assay were performed to assess the effects of RAPA on tropomyosins (TPMs) expression in patients with psoriasis, cell models and animal models. Phalloidin staining was used to assess the RAPA effects on cell skeleton. The effects of RAPA on cell proliferation and cell cycle were detected by CCK-8 assay, EdU staining and flow cytometry. Methylation status of TPMs was analysed by methylation-specific PCR. The expression of TPM1 and TPM2 was significantly downregulated, while their methylation level was obviously higher in the lesional tissues, cell models and animal models of psoriasis. After treated with RAPA, the expression and methylation levels of TPMs were all restored in the cell models and animal models of psoriasis. RAPA inhibited cell proliferation and decreased the ratio of S phase cell in Hacat or human epidermal keratinocytes cell models of psoriasis. Finally, the activated ERK1/2 and mTOR pathways in the cell model and animal model of psoriasis were suppressed by the treatment of RAPA. RAPA could be used as an effective agent for the treatment of psoriasis by decreasing the methylation level of TPM1 and TPM2 via inhibiting the ERK1/2 and mTOR signalling pathways.

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Biologics combined with conventional systemic agents or phototherapy for the treatment of psoriasis: real‐life data from PSONET registries

Cited by 32 publications

References 39 publications

Persistence of tumor necrosis factor inhibitor or conventional synthetic disease-modifying antirheumatic drug monotherapy or combination therapy in psoriatic arthritis in a real-world setting

Persistence of tumor necrosis factor inhibitor or conventional synthetic disease-modifying antirheumatic drug monotherapy or combination therapy in psoriatic arthritis in a real-world setting

Real-World Experience with Etanercept Therapy and the Switching Pattern among Korean Patients with Psoriasis after Withdrawal of Etanercept

Rapamycin ameliorates psoriasis by regulating the expression and methylation levels of tropomyosin viaERK1/2 andmTORpathways in vitro and in vivo

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