%0 Journal Article %T Drug survival and postdrug survival of first-line immunosuppressive treatments for atopic dermatitis comparison between methotrexate and cyclosporine %+ Service de Dermatologie [Rennes] = Dermatology [Rennes] %+ Laboratoire Traitement du Signal et de l'Image (LTSI) %+ Centre d'Investigation Clinique [Rennes] (CIC) %+ Clinical Data Center [CHU Rennes] %+ Service de dermatologie [CH Le Mans] %+ CHU de Saint-Brieuc %+ Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES) %A Law Ping Man, Sarah %A Bouzillé, Guillaume %A Beneton, Nathalie %A Safa, Gilles %A Dupuy, Alain %A Droitcourt, Catherine %< avec comité de lecture %@ 0926-9959 %J Journal of the European Academy of Dermatology and Venereology %I Wiley %V 32 %N 8 %P 1327-1335 %8 2018-03-06 %D 2018 %R 10.1111/jdv.14880 %M 29444359 %K immunosuppressive treatment %K atopic dermatitis %K post-drug survival %K drug survival %Z Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology %Z Life Sciences [q-bio]/Immunology/Immunotherapy %Z Life Sciences [q-bio]/Human health and pathology/DermatologyJournal articles %X IntroductionCyclosporine 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).MethodsRetrospective 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.ResultsFifty-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’.ConclusionThis 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. %G English %2 https://univ-rennes.hal.science/hal-01798651/document %2 https://univ-rennes.hal.science/hal-01798651/file/Law%20Ping%20Man%20et%20al_Drug%20survival%20and%20post-drug%20survival%20of%20first-line%20immunosuppressive%20treatments.pdf %L hal-01798651 %U https://univ-rennes.hal.science/hal-01798651 %~ INSERM %~ UNIV-RENNES1 %~ LTSI %~ HL %~ CIC %~ CIC203 %~ STATS-UR1 %~ UR1-UFR-SVE %~ UR1-HAL %~ EHESP %~ USPC %~ UR1-MATH-STIC %~ UR1-SDV %~ REPERES %~ TEST-UR-CSS %~ UNIV-RENNES %~ CHM %~ UR1-MATH-NUM %~ UR1-BIO-SA