Toggle Main Menu Toggle Search

Open Access padlockePrints

Differential Drug Survival of Biologic Therapies for the Treatment of Psoriasis: A Prospective Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR)

Lookup NU author(s): Professor Nick ReynoldsORCiD


Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


Drug survival reflects a drug's effectiveness, safety, and tolerability. We assessed the drug survival of biologics used to treat psoriasis in a prospective national pharmacovigilance cohort (British Association of Dermatologists Biologic Interventions Register (BADBIR)). The survival rates of the first course of biologics for 3,523 biologicnaive patients with chronic plaque psoriasis were compared using survival analysis techniques and predictors of discontinuation analyzed using a multivariate Cox proportional hazards model. Data for patients on adalimumab (n=1,879), etanercept (n=1,098), infliximab (n =96), and ustekinumab (n=450) were available. The overall survival rate in the first year was 77%, falling to 53% in the third year. Multivariate analysis showed that female gender (hazard ratio (HR) 1.22; 95% confidence interval (CI): 1.09-1.37), being a current smoker (HR 1.19; 95% Cl: 1.03-1.38), and a higher baseline dermatology life quality index (HR 1.01; 95% CI: 1.00-1.02) were predictors of discontinuation. Presence of psoriatic arthritis (HR 0.82; 95% Cl: 0.71-0.96) was a predictor for drug survival. As compared with adalimumab, patients on etanercept (HR 1.63; 95% Cl: 1.45-1.84) or infliximab (HR 1.56; 95% Cl: 1.16-2.09) were more likely to discontinue therapy, whereas patients on ustekinumab were more likely to persist (HR 0.48; 95% Cl: 0.37-0.62). After accounting for relevant covariates, ustekinumab had the highest first-course drug survival. The results of this study will aid clinical decision making when choosing biologic therapy for psoriasis patients.

Publication metadata

Author(s): Warren RB, Smith CH, Yiu ZZN, Ashcroft DM, Barker JNWN, Burden AD, Lunt M, McElhone K, Ormerod AD, Owen CM, Reynolds NJ, Griffiths CEM, BADBIR Study Grp

Publication type: Article

Publication status: Published

Journal: Journal of Investigative Dermatology

Year: 2015

Volume: 135

Issue: 11

Pages: 2632-2640

Print publication date: 01/11/2015

Online publication date: 04/01/2016

Acceptance date: 26/05/2015

ISSN (print): 0022-202X

ISSN (electronic): 1523-1747

Publisher: Nature Publishing Group


DOI: 10.1038/jid.2015.208


Altmetrics provided by Altmetric