1. Drug survival for ciclosporin A in a long-term daily practice cohort of adult patients with atopic dermatitis.
- Author
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Schaft, J., Politiek, K., Reek, J.M.P.A., Christoffers, W.A., Kievit, W., Jong, E.M.G.J., Bruijnzeel‐Koomen, C.A.F.M., Schuttelaar, M.L.A., and Bruin‐Weller, M.S.
- Subjects
IMMUNOSUPPRESSIVE agents ,IMMUNOPHARMACOLOGY ,ATOPIC dermatitis treatment ,ALLERGIES ,SKIN inflammation - 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. [ABSTRACT FROM AUTHOR]- Published
- 2015
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