Efficacy and Survival of Systemic Psoriasis Treatments: An Analysis of the Swiss Registry SDNTT.

Maul, Julia-Tatjana; Djamei, Vahid; Kolios, Antonios G A; Meier, Barbara; Czernielewski, Justine; Jungo, Pascal; Yawalkar, Nikhil; Mainetti, Carlo; Laffitte, Emmanuel; Spehr, Christina; Anliker, Mark; Streit, Markus; Augustin, Matthias; Rustenbach, Stephan; Conrad, Curdin; Hafner, Jürg; Boehncke, Wolf-Henning; Borradori, Luca; Gilliet, Michel; Itin, Peter; ... (2016). Efficacy and Survival of Systemic Psoriasis Treatments: An Analysis of the Swiss Registry SDNTT. Dermatology, 232(6), pp. 640-647. Karger 10.1159/000452740

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BACKGROUND The Swiss psoriasis registry SDNTT (Swiss Dermatology Network for Targeted Therapies) records the long-term safety and effectiveness of systemic treatment regimens for psoriasis. PATIENTS AND METHODS Patients with moderate to severe psoriasis are included in the SDNTT when treatment with a conventional systemic agent or biologic is initiated that was not previously used by the respective patient. Patients are followed over a 5-year period. Clinical data are obtained every 3-6 months using standardized case report forms. Here, baseline data and follow-up data for 1 year of patients included from October 2011 until December 2014 were analyzed. RESULTS Within 39 months, 323 patients from 7 tertiary dermatology centers in Switzerland were recruited in the SDNTT; 165 patients received biologics and 158 conventional systemic therapies. Patients treated with biologics had a significantly higher severity (PASI 11.3 vs. 9.2, BSA 15.6 vs.11.9, psoriatic arthritis 36.4 vs. 10.8%; p ≤ 0.005, p ≤ 0.013, p ≤ 0.001) and a longer duration of illness (19.2 vs. 14.4 years, p ≤ 0.003) compared to patients starting a conventional systemic treatment. PASI reduction was satisfying in both treatment groups, with 60.6% of patients treated with biologics achieving PASI75 after 1 year compared to 54.2% of patients receiving conventional systemic drugs (nonsignificant). On average, the drug survival in patients receiving a biologic therapy was significantly longer than those receiving conventional systemic treatments (30.5 vs. 19.2 months, p ≤ 0.001). CONCLUSIONS In the real-world setting of a prospective national therapy registry, the application of current therapeutic guidelines for patients with moderate to severe psoriasis resulted in a PASI reduction of approximately 70% within the first year of treatment, but current therapeutic targets of PASI75 and PASI90 were reached in only 58 and 36% of patients, respectively, at 1 year, highlighting a gap in efficacy between selective clinical trials and the real-world setting.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Dermatology

UniBE Contributor:

Yawalkar, Nikhil and Borradori, Luca

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1018-8665

Publisher:

Karger

Language:

English

Submitter:

Sandra Nyffenegger

Date Deposited:

26 May 2017 14:56

Last Modified:

29 Jan 2018 16:23

Publisher DOI:

10.1159/000452740

PubMed ID:

28076860

Uncontrolled Keywords:

Biologics Conventional systemic treatment Psoriasis Swiss psoriasis registry

BORIS DOI:

10.7892/boris.100049

URI:

https://boris.unibe.ch/id/eprint/100049

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