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Journal articles
Drug survival and postdrug survival of first-line immunosuppressive treatments for atopic dermatitis comparison between methotrexate and cyclosporine
Abstract : Introduction
Cyclosporine and methotrexate are the two preferred first-line immunosuppressive treatments in atopic dermatitis. The aim of this study was to compare the treatment profiles of methotrexate and cyclosporine in daily practice as the first-line immunosuppressive treatment in atopic dermatitis, using two survival analyses, ‘drug survival’ (time on the drug) and ‘postdrug survival’ (time between two drugs).
Methods
Retrospective study including patients with moderate-to-severe atopic dermatitis treated with methotrexate or cyclosporine as the first-line immunosuppressive treatment. The reasons for discontinuation of treatment were collected as follows: controlled disease, treatment failure, side event pregnancy and non-compliance. ‘Drug survival’ and ‘postdrug survival’ analyses were performed using the Kaplan–Meier method and predictive factors were analysed using uni- and multivariate Cox regression analyses.
Results
Fifty-six patients, among whom 25 patients treated with cyclosporine and 31 with methotrexate (median age: 34 ± 15 years), were included between 2007 and 2016. Reasons for discontinuation were not significantly different between ‘controlled disease’ and other reasons (P = 0.11). The median ‘drug survival’ was significantly longer for methotrexate (23 months) than for cyclosporine (8 months) (P < 0.0001). Six months from baseline, 93% of patients treated with methotrexate were still being treated vs 63% among patients treated with cyclosporine. The median of ‘postdrug survival’ was significantly longer for methotrexate (12 months) than for cyclosporine (2 months). Only treatment with CYC was a predictive factor for decreased ‘drug survival’ and ‘postdrug survival’.
Conclusion
This is the first direct comparison between methotrexate and cyclosporine as first-line immunosuppressive treatments for moderate-to-severe atopic dermatitis in daily practice. We evidenced two different treatment profiles: the duration of methotrexate administration is longer than that of cyclosporine. ‘Postdrug survival’ could be a new tool to assess the maintenance of effect of a drug after withdrawal in atopic dermatitis, and more broadly in chronic skin disease.
Cited literature [20 references]
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01798651
Contributor : Laurent Jonchère Connect in order to contact the contributor
Submitted on : Thursday, September 20, 2018 - 10:30:07 AM
Last modification on : Tuesday, October 19, 2021 - 11:29:39 AM
Long-term archiving on: : Friday, December 21, 2018 - 2:06:45 PM
Contributor : Laurent Jonchère Connect in order to contact the contributor
Submitted on : Thursday, September 20, 2018 - 10:30:07 AM
Last modification on : Tuesday, October 19, 2021 - 11:29:39 AM
Long-term archiving on: : Friday, December 21, 2018 - 2:06:45 PM
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