Drug survival in the treatment of generalized pustular psoriasis: A retrospective multicenter study.


Journal

Dermatologic therapy
ISSN: 1529-8019
Titre abrégé: Dermatol Ther
Pays: United States
ID NLM: 9700070

Informations de publication

Date de publication:
03 2021
Historique:
revised: 10 01 2021
received: 27 10 2020
accepted: 20 01 2021
pubmed: 27 1 2021
medline: 26 5 2021
entrez: 26 1 2021
Statut: ppublish

Résumé

Generalized pustular psoriasis (GPP) is a rare, potentially life-threatening inflammatory skin disease. Our aim was to assess patient and disease characteristics and analyze drug survival rates in the treatment of GPP in a real-life setting. In this retrospective study, 201 treatment series of 86 patients with GPP treated at five University Medical Centers were analyzed. Overall, excellent response was reached in 41.3% of all treatment courses, partial response in 31.4%, and nonresponse in 27.3%. Biological treatment was significantly more effective than non-biological therapies (excellent response: 47.4% vs 35.9%; P = .02). Overall, the median drug survival was 14.0 months (biologicals: 36.0 months vs nonbiologicals: 6.0 months; P < .001). The crude probability of survival was highest for secukinumab (hazard ratio [HR] of drug discontinuation compared with acitretin: 0.22), followed by ixekizumab and ustekinumab (HR: 0.38 each), adalimumab (HR: 0.59), etanercept (HR: 0.62), infliximab (HR: 0.69), cyclosporine (HR: 1.00), acitretin (reference for HR), fumaric acid esters (HR: 1.06), methotrexate (HR: 1.26), and apremilast (HR: 3.44); no drug discontinuation with guselkumab. Our results reveal high efficacy and drug survival, particularly for IL-17 and IL-(12)/23 antagonists. Thus, these biologics may be considered early in the therapeutic algorithm of GPP.

Identifiants

pubmed: 33497511
doi: 10.1111/dth.14814
doi:

Substances chimiques

Pharmaceutical Preparations 0
Interleukin-12 187348-17-0
Ustekinumab FU77B4U5Z0

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e14814

Subventions

Organisme : WOA Institution: GEORG-AUGUST-UNIVERSITAET GOTTINGEN Blended DEAL: ProjektDEAL

Informations de copyright

© 2021 The Authors. Dermatologic Therapy published by Wiley Periodicals LLC.

Références

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Auteurs

Christian Kromer (C)

Department of Dermatology, Venereology, and Allergology, University Medical Center, Göttingen, Germany.

Emilia Loewe (E)

Department of Dermatology, Venereology, and Allergology, University Medical Center, Göttingen, Germany.

Marthe-Lisa Schaarschmidt (ML)

Department of Dermatology, University Medical Center Mannheim, Mannheim, Germany.

Andreas Pinter (A)

Department of Dermatology, University Hospital Frankfurt, Frankfurt am Main, Germany.

Sascha Gerdes (S)

Psoriasis-Center, Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany.

Raphael Herr (R)

Mannheim Institute of Public Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.

Sietske Poortinga (S)

Department of Dermatology and Allergy, University Bonn, Bonn, Germany.

Rotraut Moessner (R)

Department of Dermatology, Venereology, and Allergology, University Medical Center, Göttingen, Germany.

Dagmar Wilsmann-Theis (D)

Department of Dermatology and Allergy, University Bonn, Bonn, Germany.

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