'Happy' drug survival of adalimumab, etanercept and ustekinumab in psoriasis in daily practice care: results from the Bio CAPTURE network.

Background Drug survival is a marker for treatment success. To date, no analyses relating dermatological quality-of-life measures to drug survival have been published. Objectives (i) To describe 1-year drug survival for adalimumab, etanercept and ustekinumab in a daily practice psoriasis cohort, and (ii) to introduce the concept of 'happy' drug survival, defined as Dermatology Life Quality Index ( DLQI) ≤ 5 combined with being 'on drug' at a specific time point. Methods Data were extracted from a prospective registry. Drug survival was analysed using Kaplan-Meier estimates. 'Happy' drug survival was calculated, with data split into 'happy' ( DLQI ≤ 5) vs. 'unhappy' ( DLQI > 5) at baseline and months 3, 6, 9 and 12. Results 249 treatment episodes were included (101 adalimumab, 82 etanercept, 66 ustekinumab). The 1-year drug survival rates for ustekinumab, adalimumab and etanercept were 85%, 74% and 68%, respectively. Ustekinumab showed a better confounder-corrected drug survival vs. etanercept [hazard ratio ( HR) 3·8, P = 0·02] and a trend towards better survival vs. adalimumab ( HR 2·3, P = 0·1). At baseline, the majority ( n = 115, 73%) was considered 'unhappy' and a minority 'happy' ( n = 42, 27%) (ratio 'happy':'unhappy' was 1 : 2.7). The percentage of treatment episodes with 'happy' on-drug patients increased to 79% after 1 year. Conclusions Ustekinumab showed a better overall drug survival than etanercept, and a trend towards a better overall drug survival than adalimumab. After 1 year, patients reported to be 'happy' in 79% of episodes and 'unhappy' in 21%. We introduced the new concept of 'happy' drug survival because the proportion of on-drug patients with good quality of life is an important indicator for treatment success. [ABSTRACT FROM AUTHOR]