| Title: |
The association of age at psoriasis onset and HLA-C*06:02 with biologic survival in patients with moderate-to-severe psoriasis: a cohort study from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR). |
| Authors: |
Alabas, OA; Mason, KJ; Yiu, ZZN; Warren, RB; Dand, N; Barker, JN; Smith, CH; Griffiths, CEM; BADBIR and BSTOP study group |
| Publisher Information: |
Oxford University Press |
| Publication Year: |
2023 |
| Collection: |
Queen Mary University of London: Queen Mary Research Online (QMRO) |
| Subject Terms: |
Humans; Adult; Cohort Studies; Ustekinumab; HLA-C Antigens; Dermatologists; Registries; Biological Factors; Adalimumab; Psoriasis; Etanercept; Immunologic Factors; Adjuvants; Immunologic; Biological Products; Treatment Outcome |
| Description: |
BACKGROUND: Few studies have used real-world data to investigate the association between biologic therapy survival and age at psoriasis onset or HLA-C*06:02 status in patients with moderate-to-severe psoriasis. The robustness of these studies is limited by small sample size, short follow-up and diverse safety and effectiveness measures. OBJECTIVES: To describe biologic survival and explore whether the response to biologics is modified by age at psoriasis onset or HLA-C*06:02 status in patients with moderate-to-severe psoriasis. METHODS: Data from patients in the UK and the Republic of Ireland registered in the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR) from 2007 to 2022 on a first course of adalimumab, etanercept, secukinumab or ustekinumab with at least 6 months' follow-up and a subset of BADBIR patients with available HLA-C*06:02 information registered to Biomarkers and Stratification To Optimise outcomes in Psoriasis (BSTOP) were analysed. Patients aged ≥ 50 years at treatment initiation were classified into early-onset psoriasis (EOP) (presenting in patients ≤ 40 years of age) and late-onset psoriasis (LOP) (presenting in patients > 40 years of age). BADBIR patients with available information in BSTOP were categorized as HLA-C*06:02- or HLA-C*06:02 + . Biologic survival was defined as treatment discontinuation associated with ineffectiveness or occurrence of adverse events (AEs). Adjusted survival function and hazard ratio (aHR) with 95% confidence interval (CI) were estimated using a flexible parametric model to compare discontinuing therapy between age at psoriasis onset and HLA-C*06:02 groups. Each model included exposure (biologics), effect modifier (age at onset or HLA-C*06:02 status), interaction terms and several baseline demographic, clinical and disease severity covariates. RESULTS: Final analytical cohorts included 4250 patients in the age at psoriasis onset group [2929 EOP (69%) vs. 1321 LOP (31%)] and 3094 patients in the HLA-C*06:02 status group ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
689 - 700 |
| Language: |
English |
| Relation: |
Br J Dermatol; https://qmro.qmul.ac.uk/xmlui/handle/123456789/104385 |
| DOI: |
10.1093/bjd/ljad481 |
| Availability: |
https://qmro.qmul.ac.uk/xmlui/handle/123456789/104385; https://doi.org/10.1093/bjd/ljad481 |
| Rights: |
© The Author(s) 2023. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. |
| Accession Number: |
edsbas.4CCC3EFD |
| Database: |
BASE |