Ustekinumab Bests TNF Inhibitors for Biologic Survival in Psoriasis Save

Using drug survival as a global measure of a drug's effectiveness, safety and tolerability, UK investigators used a national pharmacovigilance cohort (British Association of Dermatologists Biologic Interventions Register) to compare survival rates of the first biologic used in 3,523 biologic-naive patients with chronic plaque psoriasis.

Patients treated with adalimumab, etanercept, infliximab, or ustekinumab were compared. The overall survival rate was 77% in year 1 and this fell to 53% by year 3. Predictors of discontinuation were female gender (HR 1.22; 95% CI: 1.09-1.37), being a current smoker (HR 1.19) and a higher baseline dermatology life quality index (DLQI) (HR 1.01). A diagnosis of psoriatic arthritis predicted longer drug survival (HR 0.82; 95% CI: 0.71-0.96). In adjusted multivariate analysis, ustekinumab had the highest first-course drug survival.