Fumaric acid esters for the treatment of psoriasis in Germany: characterising patients in routine care

TY - JOUR

T1 - Fumaric acid esters for the treatment of psoriasis in Germany: characterising patients in routine care

AU - Mrowietz, Ulrich

AU - Sorbe, Christina

AU - Reich, Kristian

AU - Von Kiedrowski, Ralph

AU - Weckbecker, Jörg

AU - Radtke, Marc A

AU - Rustenbach, Stephan J

AU - Augustin, Matthias

PY - 2020/2/1

Y1 - 2020/2/1

N2 - BACKGROUND: Fumaric acid esters (FAE) represent the most widely-used oral systemic treatment for moderate-to-severe psoriasis in Germany. Not licensed outside Germany, little is known about the demographics of patients receiving FAE. PsoBest is a large national patient registry documenting long-term treatment of psoriasis in Germany.OBJECTIVES: To evaluate FAE relative to methotrexate (MTX) in patients from the PsoBest registry.MATERIALS AND METHODS: Patient demographics, disease severity at baseline and dosing regimen were reported for patients who initiated treatment with either FAE or MTX between 2007 and 2015.RESULTS: Overall, 1,409 patients treated with FAE and 877 with MTX were analysed. At baseline, compared with the MTX cohort, patients receiving FAE were younger (45.4 vs. 50.2 years; p≤0.001) and had a lower BMI (28.0 vs. 28.3 kg/m2; p≤0.023) and less nail involvement (45.4% vs. 50.7%; p≤0.013). The MTX cohort reported a greater mean duration of illness at baseline (18.2 years vs. 14.9 years; p≤0.001). In total, 85.6% and 58.5% patients in the FAE and MTX cohorts, respectively, had not received prior systemic therapy. Cardiovascular disease was the most prevalent comorbidity (FAE: 26.7%; MTX: 31.5%; p≤0.014). Health-related quality of life was similar for both cohorts (mean DLQI: 10.8 [FAE]; 10.5 [MTX]; p≤0.079). Mean FAE dose was 165.0 mg at inclusion and 406.4 mg following up-titration.CONCLUSION: This study contributes to a better understanding of the usual practices of long-term FAE use, which may also lead to improved treatment strategies not only in Germany, but in other countries where FAE may become available in the near future.

AB - BACKGROUND: Fumaric acid esters (FAE) represent the most widely-used oral systemic treatment for moderate-to-severe psoriasis in Germany. Not licensed outside Germany, little is known about the demographics of patients receiving FAE. PsoBest is a large national patient registry documenting long-term treatment of psoriasis in Germany.OBJECTIVES: To evaluate FAE relative to methotrexate (MTX) in patients from the PsoBest registry.MATERIALS AND METHODS: Patient demographics, disease severity at baseline and dosing regimen were reported for patients who initiated treatment with either FAE or MTX between 2007 and 2015.RESULTS: Overall, 1,409 patients treated with FAE and 877 with MTX were analysed. At baseline, compared with the MTX cohort, patients receiving FAE were younger (45.4 vs. 50.2 years; p≤0.001) and had a lower BMI (28.0 vs. 28.3 kg/m2; p≤0.023) and less nail involvement (45.4% vs. 50.7%; p≤0.013). The MTX cohort reported a greater mean duration of illness at baseline (18.2 years vs. 14.9 years; p≤0.001). In total, 85.6% and 58.5% patients in the FAE and MTX cohorts, respectively, had not received prior systemic therapy. Cardiovascular disease was the most prevalent comorbidity (FAE: 26.7%; MTX: 31.5%; p≤0.014). Health-related quality of life was similar for both cohorts (mean DLQI: 10.8 [FAE]; 10.5 [MTX]; p≤0.079). Mean FAE dose was 165.0 mg at inclusion and 406.4 mg following up-titration.CONCLUSION: This study contributes to a better understanding of the usual practices of long-term FAE use, which may also lead to improved treatment strategies not only in Germany, but in other countries where FAE may become available in the near future.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Comorbidity

KW - Dermatologic Agents/administration & dosage

KW - Female

KW - Fumarates/administration & dosage

KW - Germany/epidemiology

KW - Humans

KW - Hypertension/epidemiology

KW - Male

KW - Methotrexate/therapeutic use

KW - Middle Aged

KW - Prevalence

KW - Psoriasis/drug therapy

KW - Quality of Life

KW - Registries

KW - Severity of Illness Index

KW - Time Factors

KW - Young Adult

U2 - 10.1684/ejd.2020.3709

DO - 10.1684/ejd.2020.3709

M3 - SCORING: Journal article

C2 - 32250255

VL - 30

SP - 41

EP - 48

JO - EUR J DERMATOL

JF - EUR J DERMATOL

SN - 1167-1122

IS - 1

ER -