Efficacy and cost of etanercept in long-term psoriasis: Rational use in clinical practice

摘要

Introduction: The advent of the biological therapies has led health expenditure in dermatology units. This study aims to evaluate, in our regular clinical practice, the patterns of use of etanercept and its influence on efficacy and safety outcomes, as well as the real costs associated with continuous and intermittent treatment regimens. Methods: Observational, retrospective, non-interventionist, and multicenter study to analyze the experience of the treatment with etanercept in the management of moderate-to-severe plaque psoriasis, given according to the daily clinical practice of the Dermatology Departments of the Complejo Hospitalario de Jaen and the Hospital Universitario Virgen del Rocio (Seville). Results: 83.3 (n=45) of the 54 patients included in our study received the continuous regimen of Etanercept, whereas 16.7 (n=9) were given the intermittent regimen. 94.4 (n=51) of the patients studied began the Etanercept treatment at a dose of 50mg/week. The mean patient/year cost of the study population is Euro11298.80 (95CI Euro10551.40-Euro12046.20). Breaking down the first and the second year of treatment by regimen, in the continuous regimen the mean cost would be Euro12294.15 and Euro12327.05 in the first and the second year, respectively, and Euro10302.07 and Euro4986.51 in the intermittent regimen. Discussion: Etanercept is a biologic that had demonstrated its versatility over the years and permits the individualization of treatment in our patients, thus having a direct impact on drug-related costs. This is well demonstrated in our series, where 94.4 of our patients begin with the dose of 50mg/d. Our study yields relatively higher figures in patients on continuous therapy, with 77.1 of them maintaining PASI75 at week 24. Conclusions: We present our experience in regular clinical practice with etanercept, showing it to be an effective, safe, and versatile drug that permits patient-tailored treatment, delivering a frankly satisfactory control of our psoriasis patients.