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Dávila-Seijo P, Dauden E, Descalzo MA, Carretero G, Carrascosa JM, Vanaclocha F, Gómez-García FJ, De la Cueva-Dobao P, Herrera-Ceballos E, Belinchón I, López-Estebaranz JL, Alsina M, Sánchez-Carazo JL, Ferrán M, Torrado R, Ferrandiz C, Rivera R, Llamas M, Jiménez-Puya R, García-Doval I. Infections in Moderate to Severe Psoriasis Patients Treated with Biological Drugs Compared to Classic Systemic Drugs: Findings from the BIOBADADERM Registry. J Invest Dermatol 2016; 137:313-321. [PMID: 27677836 DOI: 10.1016/j.jid.2016.08.034] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/29/2016] [Accepted: 08/31/2016] [Indexed: 12/12/2022]
Abstract
Information regarding the safety of biological drugs prescribed to psoriasis patients on daily and long-term bases is insufficient. We used data from the BIOBADADERM registry (Spanish Registry of Adverse Events for Biological Therapy in Dermatological Diseases) to generate crude rates of infection during therapy with systemic drugs, including biological drugs (infliximab, etanercept, adalimumab, and ustekinumab) and nonbiological drugs (acitretin, cyclosporine, and methotrexate). We also calculated unadjusted and adjusted risk ratios (RRs) (with propensity score adjustment) of infection, serious infections, and recurrent infections of systemic therapies compared with methotrexate, using Poisson regression. Our study included records of 2,153 patients (7,867.5 person-years). The adjusted RR of overall infection was significantly increased in the groups treated with adalimumab with methotrexate (adjusted RR = 2.13, 95% confidence interval [CI] = 1.2-3.7), infliximab (adjusted RR = 1.71, 95% CI = 1.1-2.65), cyclosporine (adjusted RR = 1.58, 95% CI = 1.17-2.15), ustekinumab with methotrexate (adjusted RR = 1.56, 95% CI = 1.08-2.25), and etanercept (adjusted RR = 1.34, 95% CI: 1.02-1.76) compared with methotrexate alone. Cyclosporine had a significant risk of serious infection (adjusted RR = 3.12, 95% CI = 1.1-8.8), followed by adalimumab combined with methotrexate (adjusted RR = 3.28, 95% CI = 0.8-13.5). Adalimumab in combination with methotrexate had the highest risk of infection recurrence (adjusted RR = 4.33, 95% CI = 2.27-8.24).
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Affiliation(s)
- Paula Dávila-Seijo
- Research Unit, Fundación Academia Española de Dermatología y Venereología, Madrid, Spain; Dermatology and Venereology Department, Umeå University Hospital, Umeå, Sweden.
| | - Esteban Dauden
- Dermatology Department, Hospital Universitario La Princesa, Madrid, Spain
| | - M A Descalzo
- Research Unit, Fundación Academia Española de Dermatología y Venereología, Madrid, Spain
| | - Gregorio Carretero
- Dermatology Department, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | | | | | | | | | | | - Isabel Belinchón
- Dermatology Department, Hospital General Universitario de Alicante, Departamento de Medicina Clínica, Universidad Miguel Hernández, ISABIAL-FISABIO, Alicante, Spain
| | | | - Merce Alsina
- Dermatology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | | | - Marta Ferrán
- Dermatology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - Rosa Torrado
- Dermatology Department, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
| | - Carlos Ferrandiz
- Dermatology Department, Hospital Universitario Germans Trias i Pujol, Badalona, Spain
| | - Raquel Rivera
- Dermatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Mar Llamas
- Dermatology Department, Hospital Universitario La Princesa, Madrid, Spain
| | | | - Ignacio García-Doval
- Research Unit, Fundación Academia Española de Dermatología y Venereología, Madrid, Spain; Dermatology Derpartment, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
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