Drug survival for ciclosporin A in a long‐term daily practice cohort of adult patients with atopic dermatitis. (11th May 2015)

• Record Type: Journal Article
• Authors: van der Schaft, J.; Politiek, K.; van den Reek, J.M.P.A.; Christoffers, W.A.; Kievit, W.; de Jong, E.M.G.J.; Bruijnzeel‐Koomen, C.A.F.M.; Schuttelaar, M.L.A.; de Bruin‐Weller, M.S.
• Is Part Of: British journal of dermatology. Volume 172:Number 6(2015:Jun.)
• Page Start: 1621
• Page End: 1627
• Publication Date: 2015-05-11
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.13730
• Languages: English
• ISSNs: 0007-0963

Abstract

<abstract abstract-type="main" id="bjd13730-abs-0001"> <title>Summary</title> <sec id="bjd13730-sec-0001" sec-type="section"> <title>Background</title> <p>Long‐term data of ciclosporin A (CsA) treatment in daily practice in patients with severe atopic dermatitis (AD) are lacking.</p> </sec> <sec id="bjd13730-sec-0002" sec-type="section"> <title>Objectives</title> <p>To perform a detailed analysis of drug survival, which is the length of time a patient continues to take a drug, for CsA in a long‐term daily practice cohort of patients with AD. The secondary objective was to identify determinants of drug survival.</p> </sec> <sec id="bjd13730-sec-0003" sec-type="section"> <title>Methods</title> <p>Data were extracted from a retrospective cohort of patients treated with CsA for AD. Drug survival was analysed using Kaplan–Meier survival curves. Determinants of drug survival were analysed using uni‐ and multivariate Cox regression analyses with backward selection.</p> </sec> <sec id="bjd13730-sec-0004" sec-type="section"> <title>Results</title> <p>In total, 356 adult patients were analysed (386 patient‐years). The overall drug survival rates were 34%, 18%, 12% and 4% after 1, 2, 3 and 6 years, respectively. Reasons for discontinuation were controlled AD (26·4%), side‐effects (22·2%), ineffectiveness (16·3%), side‐effects plus ineffectiveness (6·2%) or other reasons (11·0%). Older age was associated with a decreased drug survival related to controlled AD [hazard ratio (HR) 0·91]. Older age was also associated with a decreased drug survival related to side‐effects (HR 1·14). An intermediate‐to‐high starting dose (> 3·5–5·0 mg kg<sup>−1</sup> daily) was associated with an increased drug survival related to ineffectiveness (HR 0·63).</p> </sec> <sec id="bjd13730-sec-0005" sec-type="section"> <title>Conclusions</title> <p>This is the first study on drug survival for CsA treatment in AD. Older age was associated with decreased drug survival related to controlled AD and side‐effects. An intermediate‐to‐high starting dose was associated with an increased drug survival related to ineffectiveness.</p> </sec> </abstract>