지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
초록· 키워드
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Background: The use of biologics to treat psoriasis has been increased dramatically. A considerable disease period often precedes the initiation of biologics and patients are treated with variable modalities during this period. However, there is a lack of nationwide studies examining treatment patterns before starting biologics. Objective: We investigated treatment patterns until the initiation of biologics in psoriasis patients. Methods: We conducted a retrospective cohort study using the National Health Insurance System Claims Database of Korean from January 1, 2008 to December 31, 2017, including psoriasis patients who were naïve to biologic agents [ustekinumab (UST), TNF-α inhibitor (TNFi): adalimumab, etanercept, infliximab]. We analyzed the systemic agents (acitretin, cyclosporine, methotrexate) and phototherapy prescription patterns until the initiation of biologics. Results: Among 527 patients, 6.1% (n=32) had psoriatic arthritis [UST: n=9(3.3%), TNFi: n=23(9.1%)]. In UST users (n=295), cyclosporine was prescribed more than methotrexate(76.4%, 41.3% in ever users, p<0.05), while in TNFi users (n=252), methotrexate was prescribed more than cyclosporine (77.4%, 48.4% in ever users, p<0.05). Medication patterns were as follows: monotherapy (50.5%), dual-therapy (32.6%), and triple-therapy (16.9%). TNFi users had higher median cumulative dose (0.33g) and longer duration (31 weeks) of methotrexate than UST users (0.17g, 19 weeks). The cumulative doses of methotrexate were as follows: <1 g (88.4%), 1~2 g (8.5%), 2~3 g (2.1%), and ≥3 g (0.9%). The durations of cyclosporine were as follows: <6 months (52.5%), 6~12 months (22.9%), 1~2 years (13.7%) and ≥2 years (10.8%). Ninety-two patients (17.5%) underwent phototherapy and all of them had used systemic agents. The median duration of total treatment including systemic agents and phototherapy before starting biologics was 41.5 weeks. Conclusion: Most were treated with appropriate doses and durations of systemic agents and phototherapy, but some were treated with more than those of recommended guidelines. There is no consensus about the appropriate treatment duration before starting biologics. Therefore, it is needed to consider the proper transition period for the severe patients who require rapid disease control.
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참고문헌 (14)
참고문헌 신청
최훈 / 2018 / 건선 및 건선관절염 환자에서 생물학적 제제 사용을 위한 선별 검사 / 대한건선학회지 15(2):35~41
하대룡 / 2019 / 중등증-중증의 한국인 건선 환자에서 Secukinumab의 효과와 안전성에 관한 연구 / 대한피부과학회지 57(1):9~14
임지홍 / 2017 / 한국인 건선환자 30명을 대상으로 5년동안 Ustekinumab과 Topical Agent 병용치료의 효과에 대한 후향적 연구 / 대한피부과학회지 55(3):171~177
Blauvelt A / 2017 / Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the continuous treatment of patients with moderate to severe psoriasis : Results from the phase III, double-blinded, placebo-and active comparator-controlled VOYAGE 1 trial / J Am Acad Dermatol 76:405~417
Huang YW / 2019 / Remission Duration and Long-Term Outcomes in Patients with Moderate-to-Severe Psoriasis Treated by Biologics or Tofacitinib in Controlled Clinical Trials: A 15-Year Single-Center Experience / Dermatol Ther (Heidelb) 9:553~569
하대룡 / 2019 / 중등증-중증의 한국인 건선 환자에서 Secukinumab의 효과와 안전성에 관한 연구 / 대한피부과학회지 57(1):9~14
임지홍 / 2017 / 한국인 건선환자 30명을 대상으로 5년동안 Ustekinumab과 Topical Agent 병용치료의 효과에 대한 후향적 연구 / 대한피부과학회지 55(3):171~177
Blauvelt A / 2017 / Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the continuous treatment of patients with moderate to severe psoriasis : Results from the phase III, double-blinded, placebo-and active comparator-controlled VOYAGE 1 trial / J Am Acad Dermatol 76:405~417
Huang YW / 2019 / Remission Duration and Long-Term Outcomes in Patients with Moderate-to-Severe Psoriasis Treated by Biologics or Tofacitinib in Controlled Clinical Trials: A 15-Year Single-Center Experience / Dermatol Ther (Heidelb) 9:553~569
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