Persistence and Failure Rates of Monotherapy Etanercept in Biologic-Naïve Psoriasis Patients: A Retrospective Study

August 2016 | Volume 15 | Issue 8 | Editorials | 1029 | Copyright © August 2016


Shivani P. Reddy BS,a Vidhi V. Shah BS,b Elaine J. Lin BS,c Alexander Egeberg MD PhD,d and Jashin J. Wu MDe

aUniversity of Illinois at Chicago College of Medicine, Chicago, IL
bUniversity of Missouri-Kansas City School of Medicine, Kansas City, MO
cLoma Linda University School of Medicine, Los Angeles, CA
dHerlev and Gentofte Hospital, Hellerup, Denmark
eKaiser Permanente Los Angeles Medical Center, Los Angeles, CA

median drug survival time when excluding non-biologic-naïve patients. They additionally found a 4-year drug survival rate of 40% in biologic-naïve patients, similar to our rate as illustrated by Figure 2. In comparison to a large-scale, recently published study with a 1-year survival rate of 70%, our 1-year drug survival rate was around 80%.5
Although this study is limited by 5% of patients lost to follow up, it provides response durations in a substantial cohort size that can guide expectations of patients starting biologic therapy for the first time. Our results demonstrate that the efficacy of etanercept therapy diminishes with time (Figure 2). Additionally, the biologic-naïve status of our cohort yielded data unaffected by other biologic agents, important given that studies have shown diminished efficacy in patients that switch between agents.4 Although new agents continue to be developed, dermatologists frequently prescribe etanercept therapy, and future studies should investigate methods to optimize this treatment modality and minimize treatment dissatisfaction amongst patients.

Disclosure

Dr. Wu received research funding from AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Coherus Biosciences, Dermira, Eli Lilly, Janssen, Merck, Novartis, Pfizer, Regeneron, Sandoz, and Sun Pharmaceutical Industries; he is a consultant for AbbVie, Amgen, Celgene, Dermira, Eli Lilly, Pfizer, and Sun Pharmaceutical Industries. Dr. Egeberg has received grants from Pfizer, and is a former employee of Pfizer. The other authors do not have any potential conflicts of interest.

References

  1. Papp KA, Tyring S, Lahfa M, et al. A global phase III randomized controlled trial of etanercept in psoriasis: safety, efficacy, and effect of dose reduction. Br J Dermatol. 2005;152:1304-12.
  2. Leonardi CL, Powers JL, Matheson RT, et al. Etanercept as Monotherapy in Patients with Psoriasis. N Engl J Med. 2003;349:2014-22.
  3. Van den Reek JM, van Lümig PP, Driessen RJ, et al. Determinants of drug survival for etanercept in a long-term daily practice cohort of patients with psoriasis. Br J Dermatol. 2014;170:415-24.
  4. Gniadecki R, Bang B, Bryld LE, et al. Comparison of long-term drug survival and safety of biologic agents in patients with psoriasis vulgaris. Br J Dermatol. 2015;172: 244-52.
  5. Warren RB, Smith CH, Zenas ZN, et al. Differential Drug Survival of Biologic Therapies for the Treatment of Psoriasis: A Prospective Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR). J Invest Dermatol. 2015;135:2632-40

AUTHOR CORRESPONDENCE

Jashin J. Wu MDjashinwu@gmail.com
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