Schaft, J. van der, Politiek, K., Reek, J.M.P.A. van den, Christoffers, W.A., Kievit, W., Jong, E.M.G.J. de, Bruijnzeel-Koomen, C.A., Schuttelaar, M.L., Bruin-Weller, M.S. de, Schaft, J. van der, Politiek, K., Reek, J.M.P.A. van den, Christoffers, W.A., Kievit, W., Jong, E.M.G.J. de, Bruijnzeel-Koomen, C.A., Schuttelaar, M.L., and Bruin-Weller, M.S. de
Contains fulltext : 151851.pdf (publisher's version ) (Closed access), 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.