Drug survival for ciclosporin A in a long-term daily practice cohort of adult patients with atopic dermatitis

J van der Schaft; K Politiek; J M P A van den Reek; W A Christoffers; W Kievit; E M G J de Jong; C A F M Bruijnzeel-Koomen; M L A Schuttelaar; M S de Bruin-Weller

doi:10.1111/bjd.13730

Drug survival for ciclosporin A in a long-term daily practice cohort of adult patients with atopic dermatitis

J van der Schaft, K Politiek, J M P A van den Reek, W A Christoffers, W Kievit, E M G J de Jong, C A F M Bruijnzeel-Koomen, M L A Schuttelaar, M S de Bruin-Weller

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Long-term data of ciclosporin A (CsA) treatment in daily practice in patients with severe atopic dermatitis (AD) are lacking.

OBJECTIVES: 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.

METHODS: 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.

RESULTS: 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(-1) daily) was associated with an increased drug survival related to ineffectiveness (HR 0·63).

CONCLUSIONS: 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.

Original language	English
Pages (from-to)	1621-7
Number of pages	7
Journal	British Journal of Dermatology
Volume	172
Issue number	6
DOIs	https://doi.org/10.1111/bjd.13730
Publication status	Published - Jun 2015

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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. (2015). Drug survival for ciclosporin A in a long-term daily practice cohort of adult patients with atopic dermatitis. British Journal of Dermatology, 172(6), 1621-7. https://doi.org/10.1111/bjd.13730

@article{6e22530cecc64cb09c1df0b140819ca1,

title = "Drug survival for ciclosporin A in a long-term daily practice cohort of adult patients with atopic dermatitis",

abstract = "BACKGROUND: Long-term data of ciclosporin A (CsA) treatment in daily practice in patients with severe atopic dermatitis (AD) are lacking.OBJECTIVES: 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.METHODS: 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.RESULTS: 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(-1) daily) was associated with an increased drug survival related to ineffectiveness (HR 0·63).CONCLUSIONS: 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.",

author = "{van der Schaft}, J and K Politiek and {van den Reek}, {J M P A} and Christoffers, {W A} and W Kievit and {de Jong}, {E M G J} and Bruijnzeel-Koomen, {C A F M} and Schuttelaar, {M L A} and {de Bruin-Weller}, {M S}",

note = "{\textcopyright} 2015 British Association of Dermatologists.",

year = "2015",

month = jun,

doi = "10.1111/bjd.13730",

language = "English",

volume = "172",

pages = "1621--7",

journal = "British Journal of Dermatology",

issn = "0007-0963",

publisher = "Wiley-Blackwell",

number = "6",

}

van der Schaft, J, Politiek, K, van den Reek, JMPA, Christoffers, WA, Kievit, W, de Jong, EMGJ, Bruijnzeel-Koomen, CAFM, Schuttelaar, MLA & de Bruin-Weller, MS 2015, 'Drug survival for ciclosporin A in a long-term daily practice cohort of adult patients with atopic dermatitis', British Journal of Dermatology, vol. 172, no. 6, pp. 1621-7. https://doi.org/10.1111/bjd.13730

TY - JOUR

T1 - Drug survival for ciclosporin A in a long-term daily practice cohort of adult patients with atopic dermatitis

AU - van der Schaft, J

AU - Politiek, K

AU - van den Reek, J M P A

AU - Christoffers, W A

AU - Kievit, W

AU - de Jong, E M G J

AU - Bruijnzeel-Koomen, C A F M

AU - Schuttelaar, M L A

AU - de Bruin-Weller, M S

PY - 2015/6

Y1 - 2015/6

N2 - BACKGROUND: Long-term data of ciclosporin A (CsA) treatment in daily practice in patients with severe atopic dermatitis (AD) are lacking.OBJECTIVES: 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.METHODS: 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.RESULTS: 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(-1) daily) was associated with an increased drug survival related to ineffectiveness (HR 0·63).CONCLUSIONS: 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.

AB - BACKGROUND: Long-term data of ciclosporin A (CsA) treatment in daily practice in patients with severe atopic dermatitis (AD) are lacking.OBJECTIVES: 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.METHODS: 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.RESULTS: 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(-1) daily) was associated with an increased drug survival related to ineffectiveness (HR 0·63).CONCLUSIONS: 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.

U2 - 10.1111/bjd.13730

DO - 10.1111/bjd.13730

M3 - Article

C2 - 25683671

SN - 0007-0963

VL - 172

SP - 1621

EP - 1627

JO - British Journal of Dermatology

JF - British Journal of Dermatology

IS - 6

ER -

Drug survival for ciclosporin A in a long-term daily practice cohort of adult patients with atopic dermatitis

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