Drug survival in the treatment of generalized pustular psoriasis: A retrospective multicenter study
Kromer C, Loewe E, Schaarschmidt ML, Pinter A, Gerdes S, Herr RM, Poortinga S, Moessner R, Wilsmann-Theis D (2021)
Publication Type: Journal article
Publication year: 2021
Journal
Book Volume: 34
Article Number: e14814
Journal Issue: 2
DOI: 10.1111/dth.14814
Abstract
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.
Authors with CRIS profile
Involved external institutions
Paracelsus-Elena-Klinik Kassel
Germany (DE)
Universitätsklinikum Mannheim
Germany (DE)
Universitätsklinikum Frankfurt am Main (KGU)
Germany (DE)
Universitätsklinikum Schleswig-Holstein (UKSH)
Germany (DE)
Rheinische Friedrich-Wilhelms-Universität Bonn
Germany (DE)
Ruprecht-Karls-Universität Heidelberg
Germany (DE)
Germany (DE)
Universitätsklinikum Mannheim
Germany (DE)
Universitätsklinikum Frankfurt am Main (KGU)
Germany (DE)
Universitätsklinikum Schleswig-Holstein (UKSH)
Germany (DE)
Rheinische Friedrich-Wilhelms-Universität Bonn
Germany (DE)
Ruprecht-Karls-Universität Heidelberg
Germany (DE)
How to cite
APA:
Kromer, C., Loewe, E., Schaarschmidt, M.-L., Pinter, A., Gerdes, S., Herr, R.M.,... Wilsmann-Theis, D. (2021). Drug survival in the treatment of generalized pustular psoriasis: A retrospective multicenter study. Dermatologic Therapy, 34(2). https://doi.org/10.1111/dth.14814
MLA:
Kromer, Christian, et al. "Drug survival in the treatment of generalized pustular psoriasis: A retrospective multicenter study." Dermatologic Therapy 34.2 (2021).
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