Association Between Short-Term PASI90 Achievement and Drug Survival of Biologics in Patients with Psoriasis
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Background: With accumulating evidence that achieving a 90% improvement in the Pso- riasis Area and Severity Index score (PASI90) has better correlation with improved health- related quality of life as compared to PASI75 achievement, there has been demand for estab- lishing new treatment goals for psoriasis. Objective: We investigated whether the short-term PASI90 achievement would predict lon- ger drug survival as compared to PASI75 achievement. Methods: This single-center retrospective cohort study reviewed 180 treatment series in 128 patients with plaque psoriasis, who were treated with tumor necrosis factor-alpha inhibitors (n=12), ustekinumab (n=88), secukinumab (n=23), guselkumab (n=45), and ixekizumab (n=12). The first effectiveness assessment, usually performed within 12 to 20 weeks, was considered a short-term treatment response to biologics. Results: After adjustment for covariates, time-dependent Cox proportional hazards re- gression analysis showed that moderate responders (short-term achievement of ≥PASI75 but <PASI90) were more likely to discontinue therapy than the excellent responders (short-term achievement of PASI90; adjusted hazard ratio, 3.159; 95% confidence interval, 1.180~8.457; =0.0220). Conclusion: The short-term PASI90 achievement is a better predictor of longer drug sur- vival as compared to PASI75 achievement.
Abstract
Background: With accumulating evidence that achieving a 90% improvement in the Pso- riasis Area and Severity Index score (PASI90) has better correlation with improved health- related quality of life as compared to PASI75 achievement, there has been demand for estab- lishing new treatment goals for psoriasis. Objective: We investigated whether the short-term PASI90 achievement would predict lon- ger drug survival as compared to PASI75 achievement. Methods: This single-center retrospective cohort study reviewed 180 treatment series in 128 patients with plaque psoriasis, who were treated with tumor necrosis factor-alpha inhibitors (n=12), ustekinumab (n=88), secukinumab (n=23), guselkumab (n=45), and ixekizumab (n=12). The first effectiveness assessment, usually performed within 12 to 20 weeks, was considered a short-term treatment response to biologics. Results: After adjustment for covariates, time-dependent Cox proportional hazards re- gression analysis showed that moderate responders (short-term achievement of ≥PASI75 but <PASI90) were more likely to discontinue therapy than the excellent responders (short-term achievement of PASI90; adjusted hazard ratio, 3.159; 95% confidence interval, 1.180~8.457; =0.0220). Conclusion: The short-term PASI90 achievement is a better predictor of longer drug sur- vival as compared to PASI75 achievement.
참고문헌 (25)
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