Long-term drug survival of adalimumab, infliximab, secukinumab and ustekinumab in hidradenitis suppurativa: A Danish nationwide cohort study

Ring, Hans Christian, Thorsen, Jonathan, Kirby, Brian, Ingram, John R. ORCID: https://orcid.org/0000-0002-5257-1142, Rosenø, Nana Aviaaja Lippert, Holgersen, Nikolaj, Nielsen, Valdemar W., Nikolai Thein Aagaard, David, Maul, Julia-Tatjana, Wu, Jashin J., Thyssen, Jacob P., Egeberg, Alexander and Thomsen, Simon F. 2024. Long-term drug survival of adalimumab, infliximab, secukinumab and ustekinumab in hidradenitis suppurativa: A Danish nationwide cohort study. British Journal of Dermatology 190 (5) , pp. 769-771. 10.1093/bjd/ljae042 Item availability restricted.

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Abstract

Importance: Biologics play an increasingly important role in management of moderate to severe hidradenitis suppurativa (HS). However, real-world data on long-term performance of biologics in HS are limited. Objective: To investigate drug survival of biologic therapies for HS in a real-world setting. Design, Setting, participants: We included all HS patients between January 1st, 2005 and December 31st, 2021 who were treated with biologics in the Danish hospital system. The biologics included adalimumab, anakinra, brodalumab, certolizumab pegol, etanercept, golimumab, guselkumab, infliximab, ixekizumab, secukinumab, and ustekinumab. Main outcomes and measures: Kaplan-Meier curves were utilized to show drug survival, and Cox regression models were employed to calculate adjusted (age, sex, prior number of biologic treatment series) hazard ratios (aHRs) with 95% confidence intervals (CIs) for risk of treatment discontinuation. A Sankey diagram was used to depict switching patterns. Results: A total of 452 patients (873 treatment series) were included, with a mean age of 41.4 years (standard deviation 12.8) at initiation of first biologic therapy. The most frequently used biologics were adalimumab (61.9%), infliximab (14.8%), ustekinumab (6.4%) and secukinumab (3.1%), respectively. The median (interquartile range) drug survival time was 33.0 (16.0-63.0), 34.0 (13.9-79.1), 28.6 (16.0-77.1) and13.0 (12.0-49.1) weeks for adalimumab, infliximab, ustekinumab and secukinumab, respectively. Among patients treated with adalimumab, stratified analyses showed that bio-naïve patients had a significantly longer drug survival time compared with non-naïve patients, 39.0 (IQR, 19.0-75.0) versus 26.2 (IQR, 12.0-51.7) weeks (p=0.04). For patients treated with ustekinumab, HS surgery during the treatment was associated with reduced risk of drug discontinuation (aHR 0.38, CI 95% 0.18-0.80), p=0.01. Conclusions and relevance: Long-term drug survival data are reported in HS for adalimumab, infliximab, ustekinumab and secukinumab. Among patients treated with adalimumab, bio-naïve patients had a significantly longer drug survival time compared with non-naïve patients.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Oxford University Press
ISSN:	0007-0963
Date of First Compliant Deposit:	24 February 2024
Date of Acceptance:	2 February 2024
Last Modified:	20 May 2024 13:13
URI:	https://orca.cardiff.ac.uk/id/eprint/166541

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