Efficacy of switching between tumor necrosis factor-alfa inhibitors in psoriasis: Results from the Italian Psocare Registry
Background Some studies have shown that switching patients from one tumor necrosis factor (TNF)-alfa inhibitor to another may be beneficial when they have an inadequate response or an adverse event. Objective We sought to assess the variables predicting the efficacy of the second TNF-alfa inhibitor...
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| Veröffentlicht in: | Journal of the American Academy of Dermatology 2014-02, Vol.70 (2), p.257-262.e3 |
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| creator | Piaserico, Stefano, MD, PhD Cazzaniga, Simone, PhD Math Chimenti, Sergio, MD, PhD Giannetti, Alberto, MD, PhD Maccarone, Mara, BA Picardo, Mauro, MD Peserico, Andrea, MD Naldi, Luigi, MD |
| description | Background Some studies have shown that switching patients from one tumor necrosis factor (TNF)-alfa inhibitor to another may be beneficial when they have an inadequate response or an adverse event. Objective We sought to assess the variables predicting the efficacy of the second TNF-alfa inhibitor in patients discontinuing the first TNF-alfa inhibitor. Methods Data from all 5423 consecutive patients starting TNF-alfa inhibitor therapy for psoriasis between September 2005 and September 2010 who were included in the Italian Psocare registry were analyzed. Results In 105 patients who switched to a second TNF-alfa inhibitor who had complete follow-up data, 75% improvement in the Psoriasis Area Severity Index score (PASI 75) was reached by 29% after 16 weeks and by 45.6% after 24 weeks. Patients who switched because of secondary loss of efficacy (loss of initial PASI 75 response) or adverse events/intolerance were more likely to reach PASI 75 than those who switched as a result of primary inefficacy (PASI 75 never achieved) (hazard ratio 2.7, 95% confidence interval 1.3-5.5 vs hazard ratio 2.0, 95% confidence interval 1.0-3.9 and 1, respectively). Limitations There was a small number of patients with complete follow-up data. Conclusion PASI 75 response in patients who switched from one anti–TNF-alfa agent to another was significantly reduced in patients who showed primary inefficacy of the first anti–TNF-alfa. |
| doi_str_mv | 10.1016/j.jaad.2013.10.019 |
| format | Article |
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Objective We sought to assess the variables predicting the efficacy of the second TNF-alfa inhibitor in patients discontinuing the first TNF-alfa inhibitor. Methods Data from all 5423 consecutive patients starting TNF-alfa inhibitor therapy for psoriasis between September 2005 and September 2010 who were included in the Italian Psocare registry were analyzed. Results In 105 patients who switched to a second TNF-alfa inhibitor who had complete follow-up data, 75% improvement in the Psoriasis Area Severity Index score (PASI 75) was reached by 29% after 16 weeks and by 45.6% after 24 weeks. Patients who switched because of secondary loss of efficacy (loss of initial PASI 75 response) or adverse events/intolerance were more likely to reach PASI 75 than those who switched as a result of primary inefficacy (PASI 75 never achieved) (hazard ratio 2.7, 95% confidence interval 1.3-5.5 vs hazard ratio 2.0, 95% confidence interval 1.0-3.9 and 1, respectively). Limitations There was a small number of patients with complete follow-up data. Conclusion PASI 75 response in patients who switched from one anti–TNF-alfa agent to another was significantly reduced in patients who showed primary inefficacy of the first anti–TNF-alfa.</description><identifier>ISSN: 0190-9622</identifier><identifier>EISSN: 1097-6787</identifier><identifier>DOI: 10.1016/j.jaad.2013.10.019</identifier><identifier>PMID: 24355410</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adalimumab ; Adult ; Analysis of Variance ; Antibodies, Monoclonal - administration & dosage ; Antibodies, Monoclonal, Humanized - administration & dosage ; biologics ; Cohort Studies ; Confidence Intervals ; Dermatology ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; efficacy ; Etanercept ; Female ; Follow-Up Studies ; Humans ; Immunoglobulin G - administration & dosage ; Infliximab ; Italy ; Male ; Middle Aged ; Multivariate Analysis ; Predictive Value of Tests ; primary inefficacy ; Proportional Hazards Models ; psoriasis ; Psoriasis - diagnosis ; Psoriasis - drug therapy ; Receptors, Tumor Necrosis Factor - administration & dosage ; Registries ; Retrospective Studies ; Risk Assessment ; secondary loss of efficacy ; Severity of Illness Index ; switching ; Treatment Outcome ; tumor necrosis factor-alfa inhibitors ; Tumor Necrosis Factor-alpha - antagonists & inhibitors ; Tumor Necrosis Factor-alpha - therapeutic use ; Young Adult</subject><ispartof>Journal of the American Academy of Dermatology, 2014-02, Vol.70 (2), p.257-262.e3</ispartof><rights>American Academy of Dermatology, Inc.</rights><rights>2013 American Academy of Dermatology, Inc.</rights><rights>Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-17e3f46c7d53efa077d4a0bff152bc49e919f451e381d7a1647c57faedcb49403</citedby><cites>FETCH-LOGICAL-c455t-17e3f46c7d53efa077d4a0bff152bc49e919f451e381d7a1647c57faedcb49403</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0190962213011043$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24355410$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Piaserico, Stefano, MD, PhD</creatorcontrib><creatorcontrib>Cazzaniga, Simone, PhD Math</creatorcontrib><creatorcontrib>Chimenti, Sergio, MD, PhD</creatorcontrib><creatorcontrib>Giannetti, Alberto, MD, PhD</creatorcontrib><creatorcontrib>Maccarone, Mara, BA</creatorcontrib><creatorcontrib>Picardo, Mauro, MD</creatorcontrib><creatorcontrib>Peserico, Andrea, MD</creatorcontrib><creatorcontrib>Naldi, Luigi, MD</creatorcontrib><creatorcontrib>Psocare Study Group</creatorcontrib><title>Efficacy of switching between tumor necrosis factor-alfa inhibitors in psoriasis: Results from the Italian Psocare Registry</title><title>Journal of the American Academy of Dermatology</title><addtitle>J Am Acad Dermatol</addtitle><description>Background Some studies have shown that switching patients from one tumor necrosis factor (TNF)-alfa inhibitor to another may be beneficial when they have an inadequate response or an adverse event. Objective We sought to assess the variables predicting the efficacy of the second TNF-alfa inhibitor in patients discontinuing the first TNF-alfa inhibitor. Methods Data from all 5423 consecutive patients starting TNF-alfa inhibitor therapy for psoriasis between September 2005 and September 2010 who were included in the Italian Psocare registry were analyzed. Results In 105 patients who switched to a second TNF-alfa inhibitor who had complete follow-up data, 75% improvement in the Psoriasis Area Severity Index score (PASI 75) was reached by 29% after 16 weeks and by 45.6% after 24 weeks. Patients who switched because of secondary loss of efficacy (loss of initial PASI 75 response) or adverse events/intolerance were more likely to reach PASI 75 than those who switched as a result of primary inefficacy (PASI 75 never achieved) (hazard ratio 2.7, 95% confidence interval 1.3-5.5 vs hazard ratio 2.0, 95% confidence interval 1.0-3.9 and 1, respectively). Limitations There was a small number of patients with complete follow-up data. Conclusion PASI 75 response in patients who switched from one anti–TNF-alfa agent to another was significantly reduced in patients who showed primary inefficacy of the first anti–TNF-alfa.</description><subject>Adalimumab</subject><subject>Adult</subject><subject>Analysis of Variance</subject><subject>Antibodies, Monoclonal - administration & dosage</subject><subject>Antibodies, Monoclonal, Humanized - administration & dosage</subject><subject>biologics</subject><subject>Cohort Studies</subject><subject>Confidence Intervals</subject><subject>Dermatology</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug Administration Schedule</subject><subject>efficacy</subject><subject>Etanercept</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Immunoglobulin G - administration & dosage</subject><subject>Infliximab</subject><subject>Italy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Predictive Value of Tests</subject><subject>primary inefficacy</subject><subject>Proportional Hazards Models</subject><subject>psoriasis</subject><subject>Psoriasis - diagnosis</subject><subject>Psoriasis - drug therapy</subject><subject>Receptors, Tumor Necrosis Factor - administration & dosage</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>secondary loss of efficacy</subject><subject>Severity of Illness Index</subject><subject>switching</subject><subject>Treatment Outcome</subject><subject>tumor necrosis factor-alfa inhibitors</subject><subject>Tumor Necrosis Factor-alpha - antagonists & inhibitors</subject><subject>Tumor Necrosis Factor-alpha - therapeutic use</subject><subject>Young Adult</subject><issn>0190-9622</issn><issn>1097-6787</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9v1DAQxS0EotvCF-CAfOSSZRw7cY0QUlW1UKkSiD9ny3HGXYckXmyHasWXx9EWDhw4efz0myfNe4S8YLBlwNrXw3Ywpt_WwHgRtsDUI7JhoGTVynP5mGyKApVq6_qEnKY0AIASXD4lJ7XgTSMYbMivK-e8NfZAg6Pp3me78_Md7TDfI840L1OIdEYbQ_KJOmNziJUZnaF-3vnOl28qI92nEL0pzBv6GdMy5gLHMNG8Q3qTzejNTD-lYE3EAtz5lOPhGXnizJjw-cN7Rr5dX329_FDdfnx_c3lxW1nRNLliErkTrZV9w9EZkLIXBjrnWFN3VihUTDnRMOTnrJeGtULaRjqDve2EEsDPyKuj7z6GHwumrCefLI6jmTEsSTOhQAEUi4LWR3Q9OEV0eh_9ZOJBM9Br6HrQa-h6DX3VSsRl6eWD_9JN2P9d-ZNyAd4eASxX_vQYdbIeZ4u9j2iz7oP_v_-7f9bt6OfS2vgdD5iGsMS55KeZTrUG_WWtfW2dcWAMBOe_AZVfqeE</recordid><startdate>20140201</startdate><enddate>20140201</enddate><creator>Piaserico, Stefano, MD, PhD</creator><creator>Cazzaniga, Simone, PhD Math</creator><creator>Chimenti, Sergio, MD, PhD</creator><creator>Giannetti, Alberto, MD, PhD</creator><creator>Maccarone, Mara, BA</creator><creator>Picardo, Mauro, MD</creator><creator>Peserico, Andrea, MD</creator><creator>Naldi, Luigi, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140201</creationdate><title>Efficacy of switching between tumor necrosis factor-alfa inhibitors in psoriasis: Results from the Italian Psocare Registry</title><author>Piaserico, Stefano, MD, PhD ; Cazzaniga, Simone, PhD Math ; Chimenti, Sergio, MD, PhD ; Giannetti, Alberto, MD, PhD ; Maccarone, Mara, BA ; Picardo, Mauro, MD ; Peserico, Andrea, MD ; Naldi, Luigi, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-17e3f46c7d53efa077d4a0bff152bc49e919f451e381d7a1647c57faedcb49403</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adalimumab</topic><topic>Adult</topic><topic>Analysis of Variance</topic><topic>Antibodies, Monoclonal - administration & dosage</topic><topic>Antibodies, Monoclonal, Humanized - administration & dosage</topic><topic>biologics</topic><topic>Cohort Studies</topic><topic>Confidence Intervals</topic><topic>Dermatology</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug Administration Schedule</topic><topic>efficacy</topic><topic>Etanercept</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Immunoglobulin G - administration & dosage</topic><topic>Infliximab</topic><topic>Italy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Predictive Value of Tests</topic><topic>primary inefficacy</topic><topic>Proportional Hazards Models</topic><topic>psoriasis</topic><topic>Psoriasis - diagnosis</topic><topic>Psoriasis - drug therapy</topic><topic>Receptors, Tumor Necrosis Factor - administration & dosage</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>secondary loss of efficacy</topic><topic>Severity of Illness Index</topic><topic>switching</topic><topic>Treatment Outcome</topic><topic>tumor necrosis factor-alfa inhibitors</topic><topic>Tumor Necrosis Factor-alpha - antagonists & inhibitors</topic><topic>Tumor Necrosis Factor-alpha - therapeutic use</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Piaserico, Stefano, MD, PhD</creatorcontrib><creatorcontrib>Cazzaniga, Simone, PhD Math</creatorcontrib><creatorcontrib>Chimenti, Sergio, MD, PhD</creatorcontrib><creatorcontrib>Giannetti, Alberto, MD, PhD</creatorcontrib><creatorcontrib>Maccarone, Mara, BA</creatorcontrib><creatorcontrib>Picardo, Mauro, MD</creatorcontrib><creatorcontrib>Peserico, Andrea, MD</creatorcontrib><creatorcontrib>Naldi, Luigi, MD</creatorcontrib><creatorcontrib>Psocare Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Academy of Dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Piaserico, Stefano, MD, PhD</au><au>Cazzaniga, Simone, PhD Math</au><au>Chimenti, Sergio, MD, PhD</au><au>Giannetti, Alberto, MD, PhD</au><au>Maccarone, Mara, BA</au><au>Picardo, Mauro, MD</au><au>Peserico, Andrea, MD</au><au>Naldi, Luigi, MD</au><aucorp>Psocare Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of switching between tumor necrosis factor-alfa inhibitors in psoriasis: Results from the Italian Psocare Registry</atitle><jtitle>Journal of the American Academy of Dermatology</jtitle><addtitle>J Am Acad Dermatol</addtitle><date>2014-02-01</date><risdate>2014</risdate><volume>70</volume><issue>2</issue><spage>257</spage><epage>262.e3</epage><pages>257-262.e3</pages><issn>0190-9622</issn><eissn>1097-6787</eissn><abstract>Background Some studies have shown that switching patients from one tumor necrosis factor (TNF)-alfa inhibitor to another may be beneficial when they have an inadequate response or an adverse event. Objective We sought to assess the variables predicting the efficacy of the second TNF-alfa inhibitor in patients discontinuing the first TNF-alfa inhibitor. Methods Data from all 5423 consecutive patients starting TNF-alfa inhibitor therapy for psoriasis between September 2005 and September 2010 who were included in the Italian Psocare registry were analyzed. Results In 105 patients who switched to a second TNF-alfa inhibitor who had complete follow-up data, 75% improvement in the Psoriasis Area Severity Index score (PASI 75) was reached by 29% after 16 weeks and by 45.6% after 24 weeks. Patients who switched because of secondary loss of efficacy (loss of initial PASI 75 response) or adverse events/intolerance were more likely to reach PASI 75 than those who switched as a result of primary inefficacy (PASI 75 never achieved) (hazard ratio 2.7, 95% confidence interval 1.3-5.5 vs hazard ratio 2.0, 95% confidence interval 1.0-3.9 and 1, respectively). Limitations There was a small number of patients with complete follow-up data. Conclusion PASI 75 response in patients who switched from one anti–TNF-alfa agent to another was significantly reduced in patients who showed primary inefficacy of the first anti–TNF-alfa.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24355410</pmid><doi>10.1016/j.jaad.2013.10.019</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adalimumab Adult Analysis of Variance Antibodies, Monoclonal - administration & dosage Antibodies, Monoclonal, Humanized - administration & dosage biologics Cohort Studies Confidence Intervals Dermatology Dose-Response Relationship, Drug Drug Administration Schedule efficacy Etanercept Female Follow-Up Studies Humans Immunoglobulin G - administration & dosage Infliximab Italy Male Middle Aged Multivariate Analysis Predictive Value of Tests primary inefficacy Proportional Hazards Models psoriasis Psoriasis - diagnosis Psoriasis - drug therapy Receptors, Tumor Necrosis Factor - administration & dosage Registries Retrospective Studies Risk Assessment secondary loss of efficacy Severity of Illness Index switching Treatment Outcome tumor necrosis factor-alfa inhibitors Tumor Necrosis Factor-alpha - antagonists & inhibitors Tumor Necrosis Factor-alpha - therapeutic use Young Adult |
| title | Efficacy of switching between tumor necrosis factor-alfa inhibitors in psoriasis: Results from the Italian Psocare Registry |
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