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Real-World Experience with Etanercept Therapy and the Switching Pattern among Korean Patients with Psoriasis after Withdrawal of Etanercept

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주제분류피부과학

초록

Background: The efficacy and safety of etanercept in the treatment of psoriasis has been proven, and the drug was approved for the treatment of moderate to severe psoriasis. However, there have been few studies that have presented real-world data focused on concomitant treatment during etanercept treatment, and the switching pattern after discontinuation of etanercept. Objective: To reveal the real- world treatment pattern of etanercept-based psoriasis treatment and to investigate the switching pattern after withdrawal of etanercept. Methods: We enrolled 66 patients with psoriasis who were treated with etanercept. We collected data regarding the demographic characteristics of the patients, etanercept treatment schedules, and other treatments administered during the etanercept treatment period. We also investigated the treatment pattern after the discontinuation of etanercept with emphasis on the drug-free interval and the administered treatment modalities. Results: The mean treatment duration was 22.7±26.1 months and the mean number of etanercept injections was 21.5±27.9. Thirty-six patients were administered concomitant systemic medication or phototherapy. After discontinuation of etanercept, 54 patients were followed up and 34 of these patients were administered other systemic medication or phototherapy; phototherapy and cyclosporine was the most commonly administered treatment modality and 27.4% of treatments used biologics. Conclusion: The treatment schedule for etanercept was modified according to the severity of psoriasis and concomitant treatment was administered to improve the effectiveness of treatment in the patients enrolled in the study. We also found that most patients required other treatment modalities to control psoriasis during the period of etanercept treatment.

Abstract

Background: The efficacy and safety of etanercept in the treatment of psoriasis has been proven, and the drug was approved for the treatment of moderate to severe psoriasis. However, there have been few studies that have presented real-world data focused on concomitant treatment during etanercept treatment, and the switching pattern after discontinuation of etanercept. Objective: To reveal the real- world treatment pattern of etanercept-based psoriasis treatment and to investigate the switching pattern after withdrawal of etanercept. Methods: We enrolled 66 patients with psoriasis who were treated with etanercept. We collected data regarding the demographic characteristics of the patients, etanercept treatment schedules, and other treatments administered during the etanercept treatment period. We also investigated the treatment pattern after the discontinuation of etanercept with emphasis on the drug-free interval and the administered treatment modalities. Results: The mean treatment duration was 22.7±26.1 months and the mean number of etanercept injections was 21.5±27.9. Thirty-six patients were administered concomitant systemic medication or phototherapy. After discontinuation of etanercept, 54 patients were followed up and 34 of these patients were administered other systemic medication or phototherapy; phototherapy and cyclosporine was the most commonly administered treatment modality and 27.4% of treatments used biologics. Conclusion: The treatment schedule for etanercept was modified according to the severity of psoriasis and concomitant treatment was administered to improve the effectiveness of treatment in the patients enrolled in the study. We also found that most patients required other treatment modalities to control psoriasis during the period of etanercept treatment.

참고문헌 (9)

  1. Na JI, "Low-dose etanercept therapy in moderate to severe psoriasis in Korean", J Dermatol, 35, pp.484~490 (2008)
  2. Lee JH, "A multicenter, randomized, open-label pilot trial assessing the efficacy and safety of etanercept 50 mg twice weekly followed by etanercept 25 mg twice weekly, the combination of etanercept 25 mg twice weekly and acitretin, and acitretin alone in patients with moderate to severe psoriasis", BMC Dermatol, 16, pp.11~ (2016)
  3. 최종원, "The Advantage of Cyclosporine A and Methotrexate Rotational Therapy in Long-Term Systemic Treatment for Chronic Plaque Psoriasis in a Real World Practice", Annals of Dermatology, 29(1), pp.55~60 (2017), 대한피부과학회
  4. Luger T, "An observational study to evaluate the long-term outcomes of treatment with etanercept in patients with plaque-type psoriasis", J Eur Acad Dermatol Venereol, 30, pp.1730~1741 (2016)
  5. Lebwohl M, "Combination therapy to treat moderate to severe psoriasis", J Am Acad Dermatol, 50, pp.416~430 (2004)
  6. Busard CI, "Biologics combined with conventional systemic agents or phototherapy for the treatment of psoriasis:real-life data from PSONET registries", J Eur Acad Dermatol Venereol, 32, pp.245~253 (2018)
  7. Zweegers J, "Effectiveness of biologic and conventional systemic therapies in adults with chronic plaque psoriasis in daily practice: a systematic review", Acta Derm Venereol, 96, pp.453~458 (2016)
  8. Kimball AB, "Long-term efficacy of ustekinumab in patients with moderate-to-severe psoriasis treated for up to 5 years in the PHOENIX 1 study", J Eur Acad Dermatol Venereol, 27, pp.1535~1545 (2013)
  9. Vergou T, "Five-year experience with Ustekinumab for psoriasis : real-life data of a single centre", J Eur Acad Dermatol Venereol, 31, pp.e40~e41 (2017)

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