학술논문
Age affects drug survival rates of interleukin (IL)-17 and IL-23 inhibitors in patients with plaque psoriasis: Results from a retrospective, multicentric, multi-country, cohort study.
Document Type
Academic Journal
Author
Chiricozzi A; Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica Del Sacro Cuore, Rome, Italy.; Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.; Coscarella G; Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica Del Sacro Cuore, Rome, Italy.; Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.; Puig L; Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.; Vender R; McMaster University, Hamilton, Ontario, Canada.; Yeung J; Division of Dermatology, Department of Medicine, Probity Medical Research, University of Toronto, Waterloo, Ontario, Canada.; Carrascosa JM; Department of Dermatology, Germans Trias i Pujol University Hospital (HUGTP), Autonomous University of Barcelona (UAB), Badalona, Spain.; Piaserico S; Dermatology Unit, Department of Medicine, University of Padua, Padua, Italy.; Gisondi P; Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy.; Lynde C; Department of Medicine, The Lynde Institute for Dermatology, University of Toronto, Toronto, Ontario, Canada.; Ferreira P; Dermatology Center, Hospital CUF Descobertas, Lisbon, Portugal.; Bastos PM; Dermatology Center, Hospital CUF Descobertas, Lisbon, Portugal.; Dauden E; Dermatology Department, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain.; Leite L; Clínica Médica Belém, Lisbon, Portugal.; Valerio J; Clínica Médica Belém, Lisbon, Portugal.; Del Alcázar-Viladomiu E; Department of Dermatology, Germans Trias i Pujol University Hospital (HUGTP), Autonomous University of Barcelona (UAB), Badalona, Spain.; Vilarrasa E; Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.; Llamas-Velasco M; Dermatology Department, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain.; Alessandri-Bonetti M; Department of Reconstructive and Aesthetic Plastic Surgery, University of Milan, Milan, Italy.; Messina F; Dermatology Unit, Department of Medicine, University of Padua, Padua, Italy.; Bruni M; Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy.; Di Brizzi EV; Unit of Dermatology - University of Campania Luigi Vanvitelli, Naples, Italy.; Ricceri F; Section of Dermatology, Department of Dermatological Science, University of Florence, Florence, Italy.; Nidegger A; Department of Dermatology, Lausanne University Hospital CHUV and University of Lausanne, Lausanne, Switzerland.; Hugo J; Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic.; Mufti A; Division of Dermatology, Department of Medicine, Probity Medical Research, University of Toronto, Waterloo, Ontario, Canada.; Daponte AI; Second Department of Dermatology-Venereology, Aristotle University School of Medicine, Thessaloniki, Greece.; Teixeira L; Center for Health Technology and Services Research (CINTESIS), Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS.UP), Porto, Portugal.; Balato A; Unit of Dermatology - University of Campania Luigi Vanvitelli, Naples, Italy.; Romanelli M; Department of Dermatology, University of Pisa, Pisa, Italy.; Prignano F; Section of Dermatology, Department of Dermatological Science, University of Florence, Florence, Italy.; Gkalpakiotis S; Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic.; Conrad C; Department of Dermatology, Lausanne University Hospital CHUV and University of Lausanne, Lausanne, Switzerland.; Lazaridou E; Second Department of Dermatology-Venereology, Aristotle University School of Medicine, Thessaloniki, Greece.; Rompoti N; University Hospital of Venereal and Skin Diseases 'A.Sygros', Athens, Greece.; Stratigos AJ; University Hospital of Venereal and Skin Diseases 'A.Sygros', Athens, Greece.; Nogueira M; Department of Dermatology, CAC ICBAS-CHP - Centro Académico Clínico ICBAS - CHP, Porto, Portugal.; Peris K; Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica Del Sacro Cuore, Rome, Italy.; Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.; Torres T; Department of Dermatology, CAC ICBAS-CHP - Centro Académico Clínico ICBAS - CHP, Porto, Portugal.; UMIB - Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal.; ITR - Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal.
Source
Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 9216037 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1468-3083 (Electronic) Linking ISSN: 09269959 NLM ISO Abbreviation: J Eur Acad Dermatol Venereol Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Scarce data related to the drug survival of biologic agents in psoriasis patients aged ≥65 years is available.
Objectives: To evaluate the drug survival of interleukin (IL)-23 or the IL-17 inhibitors approved for the treatment of moderate-to-severe psoriasis in elderly patients (aged ≥65 years), compared with younger adult patients (aged <65 years), and to identify clinical predictors that can influence the drug survival.
Methods: This retrospective multicentric cohort study included adult patients with moderate-to-severe psoriasis, dissecting two-patient subcohorts based on age: elderly versus younger adults. Kaplan-Meier estimator and proportional hazard Cox regression models were used for drug survival analysis.
Results: We included 4178 patients and 4866 treatment courses; 934 were elderly (1072 treatment courses), and 3244 were younger patients (3794 treatment courses). Drug survival, considering all causes of interruption, was higher in patients aged <65 years than in elderly patients overall (log-rank p < 0.006). This difference was significant for treatment courses involving IL-23 inhibitors (p < 0.001) but not for those with IL-17 inhibitors (p = 0.2). According to both uni- and multi-variable models, elder age was associated with an increased risk of treatment discontinuation (univariable analysis: HR: 1.229, 95% CI 1.062-1.422; p < 0.006; multivariable analysis: HR: 1.199, 95% CI 1.010-1.422; p = 0.0377). Anti-IL-23 agents were associated with a reduced likelihood of treatment discontinuation after adjusting for other variables (HR: 0.520, 95% CI 0.368-0.735; p < 0.001). Being previously treated with IL-17 inhibitors increased the probability of discontinuation.
Conclusion: Elderly patients with psoriasis have an increased risk of biologic treatment discontinuation compared with younger adult patients, particularly, if being treated with IL-23 inhibitors. However, in stratified analyses conducted in elderly patients, IL-23 inhibitors showed higher drug survival rates than IL-17 inhibitors.
(© 2024 European Academy of Dermatology and Venereology.)
Objectives: To evaluate the drug survival of interleukin (IL)-23 or the IL-17 inhibitors approved for the treatment of moderate-to-severe psoriasis in elderly patients (aged ≥65 years), compared with younger adult patients (aged <65 years), and to identify clinical predictors that can influence the drug survival.
Methods: This retrospective multicentric cohort study included adult patients with moderate-to-severe psoriasis, dissecting two-patient subcohorts based on age: elderly versus younger adults. Kaplan-Meier estimator and proportional hazard Cox regression models were used for drug survival analysis.
Results: We included 4178 patients and 4866 treatment courses; 934 were elderly (1072 treatment courses), and 3244 were younger patients (3794 treatment courses). Drug survival, considering all causes of interruption, was higher in patients aged <65 years than in elderly patients overall (log-rank p < 0.006). This difference was significant for treatment courses involving IL-23 inhibitors (p < 0.001) but not for those with IL-17 inhibitors (p = 0.2). According to both uni- and multi-variable models, elder age was associated with an increased risk of treatment discontinuation (univariable analysis: HR: 1.229, 95% CI 1.062-1.422; p < 0.006; multivariable analysis: HR: 1.199, 95% CI 1.010-1.422; p = 0.0377). Anti-IL-23 agents were associated with a reduced likelihood of treatment discontinuation after adjusting for other variables (HR: 0.520, 95% CI 0.368-0.735; p < 0.001). Being previously treated with IL-17 inhibitors increased the probability of discontinuation.
Conclusion: Elderly patients with psoriasis have an increased risk of biologic treatment discontinuation compared with younger adult patients, particularly, if being treated with IL-23 inhibitors. However, in stratified analyses conducted in elderly patients, IL-23 inhibitors showed higher drug survival rates than IL-17 inhibitors.
(© 2024 European Academy of Dermatology and Venereology.)