Background The high economic impact of biologic therapy justifies the need of supervising and monitoring patients treated by the requesting department (Dermatology) and service responsible of dispensing (Pharmacy).
Purpose To analyse biological therapy resolutions submitted by a commission formed by dermatologic experts.
Material and methods Descriptive, retrospective study. Applications emitted by a local commission were reviewed between September 2013 and March 2014.
The variables collected were: treatment suggestion, diagnosis, resolution, therapeutic alternative in case of refusal, PASI (>10 as initial criterium) and BSA (%) at the beginning.
Treatment adherence’s was also checked, using dispensations made by pharmacists.
Results 43 applications were collected from 38 patients. 5 were evaluated twice after a previous rejection.
Regarding to applications, 54% were Adalimumab, 19% Ustekinumab, 14% Infliximab, 7% Etanercept, 4% Metotrexate and 2% Infliximab + Metotrexate. Diagnosis included: serious plaque psoriasis (9), moderate-severe (4), severe (21); psoriasis with artropathy (4) severe hidradenitis suppurative (2). This last two requiered an Adalimumab’s use which were “off-label”.
Nine proposal were rejected: 4 with Adalimumab in serious plaque psoriasis (1), moderate-sever (1), severe (1) and with artropathy (1), 2 with Etanercept in psoriasis and artropathy and 1 Infliximab in serious plaque psoriasis.
In 89% of refusal, a therapeutic alternative was proposed: cyclosporine (2), methotrexate (4) or phototherapy (2). In another one no treatment was proposed.
From the 34 approvals, 25 patients accomplished the PASI criteria greater than 10, 3 did not and 7 did not reveal that information. Checking adherence treatment, 88% of patients continue with their treatment, 6% did not collect medication and another 6% have discontinued therapy due to incompatibility with other pathology.
Conclusion The work made by these experts can help to regulate the use of biological therapies, restricting them to patients for whom there is solid evidence to support its use, and offering a therapeutic alternative in case of refusal. The Pharmacy Service reviews patient progress and adherence treatment, thus promoting rational drug use.
References and/or Acknowledgements No conflict of interest.
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