fevereiro 12, 2019

Esta revisão sistemática foi limitada pela literatura que faltava na sobrevivência análises e definições inconsistentes de descontinuação da droga em toda a literatura.

A systematic review of the persistence and effectiveness of systemic therapies for psoríase was limited by lack of evidence and incomplete reporting in clinical practice, according to research published in the Jornal Britânico de Dermatologia.

Researchers utilized a literature search using Embase, MEDLINE, PubMed, and the Cochrane Library to identify studies that investigated persistence of therapy survival probabilities, mean or median time to therapy discontinuation, or the proportion of patients discontinuing treatment with acitretin, ciclosporin, fumaric acid esters (FAE), ou metotrexato. The observational studies reporting on persistence (therapy duration or the proportion of patients discontinuing therapy during follow-up) or effectiveness (improvements in Psoriasis Area and Severity Index [APÓS] or Physician Global Assessment [PGA]) were published between January 1, 2007, and November 1, 2017. Eight studies involving patients with moderate to severe psoriasis (N=4624) were included for analysis.

The probability of drug survival at 1 year was 23% for ciclosporin, 42% for acitretin, e 50% for methotrexate. Discontinuations due to adverse events were more common for FAE than for methotrexate (42-46% FAE vs 22% metotrexato). For discontinuations due to ineffectiveness, results were mixed (44% acitretin, 21% ciclosporin, e 33% methotrexate vs 22% FAE).

Esta revisão sistemática foi limitada pela literatura que faltava na sobrevivência análises e definições inconsistentes de descontinuação da droga em toda a literatura.

Further research is needed to fully elucidate the persistence and effectiveness of acitretin, ciclosporin, FAE, and methotrexate; reviews should include a more robust definition to minimize risk of excluding studies that used different but relevant outcome definitions.

divulgações: Vários autores declaram afiliações à indústria farmacêutica. Please see original reference for authors’ divulgações.

siga @DermAdvisor

Referência

Mason KJ, Williams S, Yiu ZZN, et al. Persistence and effectiveness of non-biologic systemic therapies for moderate-severe psoriasis in adults: a systematic review [publicado em janeiro on-line 10, 2019]. Br J Dermatol. doi:10.1111/bjd.17625