Long-term safety of nine systemic medications for psoriasis: A cohort study using the Spanish Registry of Adverse Events for Biological Therapy in Dermatological Diseases (BIOBADADERM) Registry.

adverse effects anti-TNF anti-inflammatory agents biologic agents immunosuppressive agents long-term follow-up pharmacovigilance prospective cohort psoriasis/drug therapy registries safety

Journal

Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132

Informations de publication

Date de publication:
Jul 2020
Historique:
received: 08 10 2019
revised: 05 03 2020
accepted: 08 03 2020
pubmed: 28 3 2020
medline: 22 1 2021
entrez: 28 3 2020
Statut: ppublish

Résumé

Registry studies broadly describing the safety of systemic drugs in psoriasis are needed. To describe the safety findings of the systemic drugs acitretin, adalimumab, apremilast, cyclosporine, etanercept, infliximab, methotrexate, secukinumab, and ustekinumab used for the treatment of moderate to severe psoriasis in patients included in the Spanish Registry of Adverse Events for Biological Therapy in Dermatological Diseases (BIOBADADERM) Registry. The incidence rate ratio (IRR) and adjusted IRR (including propensity scores) of identified adverse events for each drug, using methotrexate as reference, were determined by means of a prospective cohort. Our study included 2845 patients (8954 treatment cycles; 9642 patient-years). Ustekinumab and secukinumab had the lowest rate of adverse events for several of the system organ classes, with a statistically significant decreased rate ratio (IRR of <1), whereas cyclosporine and infliximab had the highest, with an increased rate ratio (IRR of ≥5). Observational study, drug allocation not randomized, depletion of susceptibles, and prescribed doses not registered. Our data provide comparative safety information in the real-life setting that could help clinicians selecting between available products.

Sections du résumé

BACKGROUND BACKGROUND
Registry studies broadly describing the safety of systemic drugs in psoriasis are needed.
OBJECTIVE OBJECTIVE
To describe the safety findings of the systemic drugs acitretin, adalimumab, apremilast, cyclosporine, etanercept, infliximab, methotrexate, secukinumab, and ustekinumab used for the treatment of moderate to severe psoriasis in patients included in the Spanish Registry of Adverse Events for Biological Therapy in Dermatological Diseases (BIOBADADERM) Registry.
METHODS METHODS
The incidence rate ratio (IRR) and adjusted IRR (including propensity scores) of identified adverse events for each drug, using methotrexate as reference, were determined by means of a prospective cohort.
RESULTS RESULTS
Our study included 2845 patients (8954 treatment cycles; 9642 patient-years). Ustekinumab and secukinumab had the lowest rate of adverse events for several of the system organ classes, with a statistically significant decreased rate ratio (IRR of <1), whereas cyclosporine and infliximab had the highest, with an increased rate ratio (IRR of ≥5).
LIMITATIONS CONCLUSIONS
Observational study, drug allocation not randomized, depletion of susceptibles, and prescribed doses not registered.
CONCLUSION CONCLUSIONS
Our data provide comparative safety information in the real-life setting that could help clinicians selecting between available products.

Identifiants

pubmed: 32213306
pii: S0190-9622(20)30451-5
doi: 10.1016/j.jaad.2020.03.033
pii:
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

139-150

Investigateurs

Esteban Daudén (E)
Mar Llamas-Velasco (M)
Gregorio Carretero (G)
Jaime Vilar-Alejo (J)
Raquel Rivera (R)
Carmen García-Donoso (C)
Carlos Ferrándiz (C)
José Manuel Carrascosa (JM)
Ferrán Ballescá (F)
Pablo de la Cueva (P)
Isabel Belinchón (I)
Fran J Gómez-García (FJ)
Rafael Jiménez (R)
Enrique Herrera-Ceballos (E)
Enrique Herrera-Acosta (E)
José Luis López-Estebaranz (JL)
Diana Patricia Ruiz-Genao (DP)
Marta Ferrán Farrés (MF)
Mercè Alsina (M)
Ofelia Baniandrés (O)
Lula Nieto (L)
José Luis Sánchez-Carazo (JL)
Antonio Sahuquillo-Torralba (A)
Rafael Botella-Estrada (R)
Conrad Pujol Marco (CP)
Lourdes Rodríguez Fernández-Freire (LR)
Almudena Mateu Puchades (AM)
Ángeles Flórez Menéndez (ÁF)
Laura Salgado (L)
Beatriz González Sixto (BG)
Noemí Eiris (N)
Ignacio García-Doval (I)
Miguel Ángel Descalzo Gallego (MÁ)
Marina de Vega Martínez (M)

Informations de copyright

Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Auteurs

Esteban Daudén (E)

Department of Dermatology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa (IIS-IP), Madrid, Spain. Electronic address: estebandauden@gmail.com.

Gregorio Carretero (G)

Department of Dermatology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain.

Raquel Rivera (R)

Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain.

Carlos Ferrándiz (C)

Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, and Universidad Autónoma de Barcelona, Badalona, Spain.

Mar Llamas-Velasco (M)

Department of Dermatology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa (IIS-IP), Madrid, Spain.

Pablo de la Cueva (P)

Department of Dermatology, Hospital Universitario Infanta Leonor, Madrid, Spain.

Isabel Belinchón (I)

Department of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain.

Francisco José Gómez-García (FJ)

Department of Dermatology, Hospital Universitario Reina Sofía, Cordoba, Spain.

Enrique Herrera-Acosta (E)

Department of Dermatology, Hospital Universitario Virgen de la Victoria, Málaga, Spain.

Diana Patricia Ruiz-Genao (DP)

Department of Dermatology, Hospital Universitario Fundación Alcorcón, Madrid, Spain.

Marta Ferrán-Farrés (M)

Department of Dermatology, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.

Mercè Alsina (M)

Department of Dermatology, Hospital Clínic de Barcelona, UB, Barcelona, Spain.

Ofelia Baniandrés-Rodríguez (O)

Department of Dermatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

José Luis Sánchez-Carazo (JL)

Department of Dermatology, Hospital General Universitario de Valencia, Valencia, Spain.

Antonio Sahuquillo-Torralba (A)

Department of Dermatology, Hospital Universitario y Politécnico La Fe, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain.

Lourdes Rodriguez Fernández-Freire (LR)

Department of Dermatology, Hospital Virgen del Rocío, Sevilla, Spain.

Jaime Vilar-Alejo (J)

Department of Dermatology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain.

Carmen García-Donoso (C)

Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain.

José Manuel Carrascosa (JM)

Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, and Universidad Autónoma de Barcelona, Badalona, Spain.

Enrique Herrera-Ceballos (E)

Department of Dermatology, Hospital Universitario Virgen de la Victoria, Málaga, Spain.

José Luis López-Estebaranz (JL)

Department of Dermatology, Hospital Universitario Fundación Alcorcón, Madrid, Spain.

Rafael Botella-Estrada (R)

Department of Dermatology, Hospital Universitario y Politécnico La Fe, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Universidad de Valencia, Valencia, Spain.

Eva Segovia-Muñoz (E)

Evaluation Unit, Pharmacovigilance Department, Spanish Medicines and Health Products Agency (AEMPS), Madrid, Spain.

Miguel Angel Descalzo (MA)

Research Unit, Fundación Piel Sana Academia Española de Dermatología, Madrid, Spain.

Ignacio García-Doval (I)

Research Unit, Fundación Piel Sana Academia Española de Dermatología, Madrid, Spain; Department of Dermatology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain.

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Classifications MeSH