227 Real-world drug discontinuation of acitretin (ACI), ciclosporin (CsA), fumaric acid esters (FAE) and methotrexate (MTX) in patients with moderate-severe psoriasis

Mason, K.J.

Abstract

Real-world discontinuation of ACI, CsA, FAE and MTX in patients with moderate-severe psoriasis is poorly characterised. The aim of this study was to determine whether treatment history affects the discontinuation rates of these therapies. The British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR) is a pharmacovigilance register of systemic therapies for psoriasis. In total, 4115 patients registering to BADBIR from 2007-2017 on ACI, CsA, FAE or MTX with at least 6 months of follow-up were analysed. Exposure time was calculated from initiation to: discontinuation date; censor at the latest follow-up; or death. Patients were categorised as incident (first systemic), prevalent (previously prescribed registration therapy), or previous systemic users (previously prescribed another systemic). Cumulative incidence was used to determine the mean proportion (%) of patients discontinuing therapy in the first two years of follow-up. In total, 767 (19%), 1022 (25%), 335 (8%) and 1991 (48%) patients registered to ACI, CsA, FAE and MTX, respectively. The proportions of incident, prevalent and previous systemic users, respectively, were similar for ACI (42%; 16%; 42%), CsA (38%; 16%; 46%) and MTX (41%; 18%; 41%) with 66% previous systemic users registering on FAE (19% incident; 15% prevalent). The overall mean discontinuation rates at two years were: 31% ACI (95% confidence interval 27-34), 41% CsA (38-45), 27% FAE (19-43) and 26% MTX (23-28) for incident users; 33% ACI (27-39), 40% CsA (35-44), 34% FAE (25-46) and 26% MTX (23-29) for prevalent users; and 36% ACI (33-40), 39% CsA (36-42), 35% FAE (31-39) and 31% MTX (29-33) for previous systemic users, respectively. In conclusion, patients with previous systemic use prior to ACI or MTX registration had higher discontinuation rates than incident or prevalent users. These findings require further exploration to determine if stop reasons or predictors of treatment discontinuation differ between categories.

Citation

Mason, K. (2019). 227 Real-world drug discontinuation of acitretin (ACI), ciclosporin (CsA), fumaric acid esters (FAE) and methotrexate (MTX) in patients with moderate-severe psoriasis. Journal of Investigative Dermatology, 139(5), S39. https://doi.org/10.1016/j.jid.2019.03.303

• Journal Article Type: Conference Paper
• Conference Name: Society for Investigative Dermatology (SID) 2019; 8-11 May 2019
• Conference Location: Hilton Chicago, Chicago, Illinois, USA
• Publication Date: 2019-05
• Deposit Date: Jun 27, 2023
• Journal: Journal of Investigative Dermatology
• Print ISSN: 0022-202X
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 139
• Issue: 5
• Pages: S39
• DOI: https://doi.org/10.1016/j.jid.2019.03.303
• Keywords: Cell Biology; Dermatology; Molecular Biology; Biochemistry
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0022202X19304944
• Additional Information: This article is maintained by: Elsevier; Article Title: 227 Real-world drug discontinuation of acitretin (ACI), ciclosporin (CsA), fumaric acid esters (FAE) and methotrexate (MTX) in patients with moderate-severe psoriasis; Journal Title: Journal of Investigative Dermatology; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.jid.2019.03.303; Content Type: simple-article; Copyright: Copyright © 2019 Published by Elsevier Inc.