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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Dermatology journals have recently published numerous articles using drug survival analysis&#44; which assumes that a drug &#8220;surviving&#8221; longer in treatment will be one that is safer and&#47;or more effective&#46; Is this actually the case&#63;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Survival analysis involves a series of statistical techniques to study time until the occurrence of an event of interest&#46; Initially that event was death&#44; hence the name&#44; and death continues to be the endpoint in many studies&#46; However&#44; the application of survival analysis has broadened to make room for the study of time elapsing between many types of events&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">One recent application is the study of drug survival&#44; defined as the time a patient continues to take a medication&#46; This concept has been used in various chronic diseases&#8212;rheumatoid arthritis for example&#8212;as a proxy for the overall effectiveness of a therapy&#44; given survival&#39;s association with efficacy&#44; side effects&#44; and patient satisfaction&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">We now have a growing number of publications describing the survival of systemic treatments for moderate to severe psoriasis&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">1&#8211;8</span></a> Why has this type of analysis emerged in this setting&#63;</p><p id="par0025" class="elsevierStylePara elsevierViewall">In our opinion&#44; 2 factors are mainly responsible for these studies&#46; The first is the pressure to obtain real-life data on the treatment of psoriasis&#46; The second is that survival analysis requires little information&#44; merely the dates for starting and ending treatment and the reason for withdrawing the drug&#46; There is no need for a control group or repeated measures of clinical variables&#46; Many drug survival studies have no control groups and do not measure effectiveness&#44; preventing them from using other approaches to obtain more significant results&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Because drug survival is associated with many variables&#44; however&#44; it is difficult to interpret&#46; Comparisons between different studies or different drugs are generally impossible&#44; and many discrepant findings are generated&#46; We will discuss some of the problems these studies present&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Although defining the moment treatment stops may seem straightforward&#44; in fact it is not&#46; Some therapies are given intermittently&#44; and some regimens include temporary interruptions&#46; Many studies fail to state how the end of treatment is defined while others indicate that a treatment has stopped after a fixed period off treatment or a certain number of lost doses&#46; Using the loss of one or several doses as the definition of withdrawal of a drug means that it is much more difficult to study end of treatment with medications that have long dosing intervals &#40;such as infliximab or ustekinumab&#44; which are given at intervals of 8 and 12 weeks&#44; respectively&#41; than it is to study other biologics or traditional systemic medications&#46; A patient would have to be off ustekinumab for 24 weeks before treatment could be said to have stopped&#46; In contrast&#44; withdrawal of treatment with acitretin could be recorded after 2 days off treatment&#46; The period would be 2 weeks for methotrexate or etanercept&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Another important aspect to consider is that events &#40;thresholds or marker cutoffs&#41; that lead to suspending a treatment differ from one drug to another&#44; between prescribers&#44; between patients&#44; and over time&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Thresholds differ from drug to drug because of intervals between doses and concerns about safety&#46; Clinical practice routines also play a role&#46; Suspension of treatment due to adverse effects is less likely to occur when there is a long interval between treatments&#46; If the patient describes a problem with a drug whose next dose is to be administered months later&#44; adverse effects that have long passed will probably not have much influence on the decision to suspend treatment or not&#46; In contrast&#44; decisions about whether or not to stop a drug like ciclosporin that is taken every 12<span class="elsevierStyleHsp" style=""></span>hours will have to be made daily&#44; so adverse events are more likely to lead to suspension&#46; These factors probably lead to longer survival times for ustekinumab and infliximab&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Another consideration is that traditional systemic treatments for psoriasis are used intermittently because of concerns about toxic effects on specific organs due to cumulative exposure&#46; The best example of a drug prescribed for short periods of time is ciclosporin&#44; as treatment lasting longer than a year increases the risk of adverse effects &#40;nephrotoxicity&#41;&#46; In comparison with traditional therapies&#44; biologics do not seem to present a problem of toxicity over the long term&#44; and current research suggests that continuous therapy improves disease control and quality of life&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> When a patient is started on a biologic&#44; long-term use is likely to be assumed&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Approaches to treatment are different in rheumatic diseases and psoriasis&#46; Optimal control of inflammation through long-term therapy&#44; in the interest of preventing sequelae&#44; is the goal in rheumatic diseases&#46; In psoriasis&#44; there is insufficient evidence that preventing damage over the long term can be achieved through continuous treatment&#46; This uncertainty&#44; along with doubts about the long-term safety of biologics and concerns about their cost can lead some prescribers to prefer intermittent treatment whenever possible&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">A randomized controlled trial showed that continuous therapy with some drugs&#8212;such as infliximab&#8212;is more effective&#44; safer&#44; and leads to fewer serious reactions related to the infusion&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> This finding may explain why infliximab survives longer than other inhibitors of tumor necrosis factor &#40;TNF&#41; in some trials&#44; especially when remission is the endpoint of interest&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">10&#44;11</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Criteria for interrupting treatment and withdrawing a drug can also vary between patients&#46; Prior clinical history may be a factor in deciding to stop treatment&#46; It seems reasonable that response to previous therapies or adverse effects would influence the survival of drugs tried later&#44; especially if they share a chemical structure or their mechanisms of action target the same molecular pathway&#46; For example&#44; if a patient does not respond well to one anti-TNF agent&#44; the prescriber may tend to stop another such agent tried at a later time if improvement fails to come as quickly as expected&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">The criteria for suspending treatment specified in a drug&#39;s summary of product characteristics &#40;SPC&#41; may also change over time&#46; Etanercept was the first anti-TNF agent on the market and its SPC has changed since it was approved&#46; The recommended dosage in 2006 was 25<span class="elsevierStyleHsp" style=""></span>mg twice weekly&#44; and treatment was to continue until remission or up to 24 weeks&#46; If retreatment with etanercept became necessary&#44; the old recommendation called for applying the same criteria regarding duration of therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">13</span></a> However&#44; since September 2009&#44; the European Medicines Agency&#39;s label for etanercept recognizes the possibility of extending treatment beyond 24 weeks for some adults&#44; and the decision to treat intermittently or continuously can be tailored to the individual if the physician considers it necessary&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">14</span></a> Such differences appearing over time have the potential to influence etanercept&#39;s survival rates in comparison with other biologics that were recommended for continuous therapy from the start if researchers gather data from registries started before the SPC changes&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Another issue to consider is that more biologics have entered the market over time&#44; raising expectations of effectiveness&#46; This situation may be leading to more treatment suspensions in recent years&#44; as patients are switched to another drug&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Drug costs also change over time&#44; possibly affecting the survival of drugs used to treat psoriasis&#46; Since the world economic crisis began in 2008&#44; the Spanish national health service has tried to reduce spending on expensive therapies<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">15</span></a> through measures like requiring prescriptions&#44; extending the time a patient is kept on certain drugs even if response is not optimal&#44; or promoting intermittent use or switches to cheaper medications&#46; All such changes distort drug survival analyses&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Yet another problem with drug survival studies is that the reasons for treatment interruption include both positive outcomes &#40;such as remission&#41; and negative ones &#40;such as adverse events or lack of effectiveness&#41;&#46; We also see a nonnegligible number of reasons for stopping treatment that do not fit into either of these categories and that are difficult to interpret&#46; Some 15&#37; of cases in the Biobadaderm registry involve such reasons&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> Some drug survival studies group all reasons for suspension together&#44; making their findings even more difficult to grasp and compare&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Finally&#44; a more general criticism of drug survival analysis in psoriasis concerns the very research question being asked in these studies&#58; Is it truly important for patients and clinicians to know which treatments survive longer&#63; What is really important is which treatments are more effective or safer&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">In summary&#44; we believe that drug survival studies do not offer a good way to evaluate the safety or effectiveness of psoriasis treatments and that they are particularly inappropriate for comparing treatments&#46; In a recent study utilizing Biobadaderm registry data we showed that drug survival used as a proxy indicator of safety was misleading&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> The best way to measure safety&#44; we think&#44; is to publish the rates of adverse events in cohort studies&#46; Effectiveness is best demonstrated through experimental or observational studies in which effectiveness is specified as the outcome measure&#46; Drug survival analysis&#44; with all its inherent problems&#44; may be of interest mainly for generating models to assess treatment cost&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">P&#46; D&#225;vila-Seijo has received grants from Pfizer and Janssen to attend conferences&#46; I&#46; Garc&#237;a-Doval has received grants from Pfizer&#44; Janssen&#44; and Merck&#47;Schering-Plough Pharmaceuticals to attend conferences&#46;</p></span></span>"
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                        "paginaFinal" => "2640"
                        "link" => array:1 [
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                            "web" => "Medline"
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              "etiqueta" => "4"
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                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
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                        "link" => array:1 [
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                            "web" => "Medline"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of long-term drug survival and safety of biologic agents in patients with psoriasis vulgaris"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
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                            2 => "L&#46;E&#46; Bryld"
                            3 => "L&#46; Iversen"
                            4 => "S&#46; Lasthein"
                            5 => "L&#46; Skov"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2014"
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                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "6"
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                    0 => array:2 [
                      "titulo" => "Survival rate of antitumour necrosis factor-&#945; treatments for psoriasis in routine dermatological practice&#58; A multicentre observational study"
                      "autores" => array:1 [
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                          "etal" => true
                          "autores" => array:6 [
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                            2 => "N&#46; Cassano"
                            3 => "G&#46; Ferrucci"
                            4 => "M&#46; del Giglio"
                            5 => "F&#46; Loconsole"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/bjd.12422"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2013"
                        "volumen" => "169"
                        "paginaInicial" => "666"
                        "paginaFinal" => "672"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23647206"
                            "web" => "Medline"
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                    ]
                  ]
                ]
              ]
            ]
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                      "titulo" => "&#8220;Happy&#8221; drug survival of adalimumab&#44; etanercept and ustekinumab in psoriasis in daily practice care&#58; Results from the BioCAPTURE network"
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                            3 => "M&#46;E&#46; Otero"
                            4 => "P&#46;P&#46; van Lumig"
                            5 => "R&#46;J&#46; Driessen"
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                        ]
                      ]
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                  "host" => array:1 [
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                        "volumen" => "171"
                        "paginaInicial" => "1189"
                        "paginaFinal" => "1196"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24807471"
                            "web" => "Medline"
                          ]
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                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0120"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Drug survival rates of biologic treatments in patients with psoriasis vulgaris"
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                    ]
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                  "host" => array:1 [
                    0 => array:2 [
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                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2012"
                        "volumen" => "166"
                        "paginaInicial" => "447"
                        "paginaFinal" => "449"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21801162"
                            "web" => "Medline"
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                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Continuous versus intermittent therapy for moderate-to-severe psoriasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;K&#46; Ramirez-Fort"
                            1 => "A&#46;A&#46; Levin"
                            2 => "S&#46;C&#46; Au"
                            3 => "A&#46;B&#46; Gottlieb"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Rheumatol"
                        "fecha" => "2013"
                        "volumen" => "31"
                        "paginaInicial" => "S63"
                        "paginaFinal" => "S70"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24129141"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A randomized comparison of continuous vs intermittent infliximab maintenance regimens over 1 year in the treatment of moderate-to-severe plaque psoriasis"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            1 => "S&#46;R&#46; Feldman"
                            2 => "G&#46;D&#46; Weinstein"
                            3 => "K&#46; Papp"
                            4 => "R&#46; Evans"
                            5 => "C&#46; Guzzo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2007"
                        "volumen" => "56"
                        "paginaInicial" => "31e1"
                        "paginaFinal" => "31e15"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy and safety of infliximab as continuous or intermittent therapy in patients with moderate-to-severe plaque psoriasis&#58; Results of a randomized&#44; long-term extension trial &#40;RESTORE2&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
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                            1 => "G&#46; Wozel"
                            2 => "H&#46; Zheng"
                            3 => "H&#46;J&#46; van Hoogstraten"
                            4 => "L&#46; Flint"
                            5 => "J&#46; Barker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
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                        "fecha" => "2013"
                        "volumen" => "168"
                        "paginaInicial" => "1325"
                        "paginaFinal" => "1334"
                        "link" => array:1 [
                          0 => array:2 [
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                            "web" => "Medline"
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                      ]
                    ]
                  ]
                ]
              ]
            ]
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                    0 => array:2 [
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                            4 => "M&#46;A&#46; Descalzo"
                            5 => "L&#46; Carmona"
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                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
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                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2012"
                        "volumen" => "71"
                        "paginaInicial" => "382"
                        "paginaFinal" => "385"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21998116"
                            "web" => "Medline"
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                        ]
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                    ]
                  ]
                ]
              ]
            ]
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                0 => array:1 [
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              ]
            ]
            13 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "14"
              "referencia" => array:1 [
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                    0 => array:2 [
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                        "tituloSerie" => "Enferm Clin"
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                        "volumen" => "22"
                        "paginaInicial" => "179"
                        "paginaFinal" => "181"
                        "link" => array:1 [
                          0 => array:2 [
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                      ]
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                ]
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            ]
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Opinion Article
Drug Survival Analysis Is Not a Good Method for Assessing the Safety or Effectiveness of Systemic Therapies in Psoriasis
El análisis de supervivencia no es un buen método para evaluar la seguridad o la efectividad de los tratamientos sistémicos en psoriasis
P. Dávila-Seijoa,b,
Corresponding author
pauladavilaseijo@gmail.com

Corresponding author.
, I. García-Dovalb,c
a Servicio de Dermatología, Hospital Universitario de Umeå, Umeå, Suecia
b Unidad de Investigación, Fundación Academia Española de Dermatología y Venereología, Madrid, España
c Servicio de Dermatología, Complexo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Dermatology journals have recently published numerous articles using drug survival analysis&#44; which assumes that a drug &#8220;surviving&#8221; longer in treatment will be one that is safer and&#47;or more effective&#46; Is this actually the case&#63;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Survival analysis involves a series of statistical techniques to study time until the occurrence of an event of interest&#46; Initially that event was death&#44; hence the name&#44; and death continues to be the endpoint in many studies&#46; However&#44; the application of survival analysis has broadened to make room for the study of time elapsing between many types of events&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">One recent application is the study of drug survival&#44; defined as the time a patient continues to take a medication&#46; This concept has been used in various chronic diseases&#8212;rheumatoid arthritis for example&#8212;as a proxy for the overall effectiveness of a therapy&#44; given survival&#39;s association with efficacy&#44; side effects&#44; and patient satisfaction&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">We now have a growing number of publications describing the survival of systemic treatments for moderate to severe psoriasis&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">1&#8211;8</span></a> Why has this type of analysis emerged in this setting&#63;</p><p id="par0025" class="elsevierStylePara elsevierViewall">In our opinion&#44; 2 factors are mainly responsible for these studies&#46; The first is the pressure to obtain real-life data on the treatment of psoriasis&#46; The second is that survival analysis requires little information&#44; merely the dates for starting and ending treatment and the reason for withdrawing the drug&#46; There is no need for a control group or repeated measures of clinical variables&#46; Many drug survival studies have no control groups and do not measure effectiveness&#44; preventing them from using other approaches to obtain more significant results&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Because drug survival is associated with many variables&#44; however&#44; it is difficult to interpret&#46; Comparisons between different studies or different drugs are generally impossible&#44; and many discrepant findings are generated&#46; We will discuss some of the problems these studies present&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Although defining the moment treatment stops may seem straightforward&#44; in fact it is not&#46; Some therapies are given intermittently&#44; and some regimens include temporary interruptions&#46; Many studies fail to state how the end of treatment is defined while others indicate that a treatment has stopped after a fixed period off treatment or a certain number of lost doses&#46; Using the loss of one or several doses as the definition of withdrawal of a drug means that it is much more difficult to study end of treatment with medications that have long dosing intervals &#40;such as infliximab or ustekinumab&#44; which are given at intervals of 8 and 12 weeks&#44; respectively&#41; than it is to study other biologics or traditional systemic medications&#46; A patient would have to be off ustekinumab for 24 weeks before treatment could be said to have stopped&#46; In contrast&#44; withdrawal of treatment with acitretin could be recorded after 2 days off treatment&#46; The period would be 2 weeks for methotrexate or etanercept&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Another important aspect to consider is that events &#40;thresholds or marker cutoffs&#41; that lead to suspending a treatment differ from one drug to another&#44; between prescribers&#44; between patients&#44; and over time&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Thresholds differ from drug to drug because of intervals between doses and concerns about safety&#46; Clinical practice routines also play a role&#46; Suspension of treatment due to adverse effects is less likely to occur when there is a long interval between treatments&#46; If the patient describes a problem with a drug whose next dose is to be administered months later&#44; adverse effects that have long passed will probably not have much influence on the decision to suspend treatment or not&#46; In contrast&#44; decisions about whether or not to stop a drug like ciclosporin that is taken every 12<span class="elsevierStyleHsp" style=""></span>hours will have to be made daily&#44; so adverse events are more likely to lead to suspension&#46; These factors probably lead to longer survival times for ustekinumab and infliximab&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Another consideration is that traditional systemic treatments for psoriasis are used intermittently because of concerns about toxic effects on specific organs due to cumulative exposure&#46; The best example of a drug prescribed for short periods of time is ciclosporin&#44; as treatment lasting longer than a year increases the risk of adverse effects &#40;nephrotoxicity&#41;&#46; In comparison with traditional therapies&#44; biologics do not seem to present a problem of toxicity over the long term&#44; and current research suggests that continuous therapy improves disease control and quality of life&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> When a patient is started on a biologic&#44; long-term use is likely to be assumed&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Approaches to treatment are different in rheumatic diseases and psoriasis&#46; Optimal control of inflammation through long-term therapy&#44; in the interest of preventing sequelae&#44; is the goal in rheumatic diseases&#46; In psoriasis&#44; there is insufficient evidence that preventing damage over the long term can be achieved through continuous treatment&#46; This uncertainty&#44; along with doubts about the long-term safety of biologics and concerns about their cost can lead some prescribers to prefer intermittent treatment whenever possible&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">A randomized controlled trial showed that continuous therapy with some drugs&#8212;such as infliximab&#8212;is more effective&#44; safer&#44; and leads to fewer serious reactions related to the infusion&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> This finding may explain why infliximab survives longer than other inhibitors of tumor necrosis factor &#40;TNF&#41; in some trials&#44; especially when remission is the endpoint of interest&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">10&#44;11</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Criteria for interrupting treatment and withdrawing a drug can also vary between patients&#46; Prior clinical history may be a factor in deciding to stop treatment&#46; It seems reasonable that response to previous therapies or adverse effects would influence the survival of drugs tried later&#44; especially if they share a chemical structure or their mechanisms of action target the same molecular pathway&#46; For example&#44; if a patient does not respond well to one anti-TNF agent&#44; the prescriber may tend to stop another such agent tried at a later time if improvement fails to come as quickly as expected&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">The criteria for suspending treatment specified in a drug&#39;s summary of product characteristics &#40;SPC&#41; may also change over time&#46; Etanercept was the first anti-TNF agent on the market and its SPC has changed since it was approved&#46; The recommended dosage in 2006 was 25<span class="elsevierStyleHsp" style=""></span>mg twice weekly&#44; and treatment was to continue until remission or up to 24 weeks&#46; If retreatment with etanercept became necessary&#44; the old recommendation called for applying the same criteria regarding duration of therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">13</span></a> However&#44; since September 2009&#44; the European Medicines Agency&#39;s label for etanercept recognizes the possibility of extending treatment beyond 24 weeks for some adults&#44; and the decision to treat intermittently or continuously can be tailored to the individual if the physician considers it necessary&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">14</span></a> Such differences appearing over time have the potential to influence etanercept&#39;s survival rates in comparison with other biologics that were recommended for continuous therapy from the start if researchers gather data from registries started before the SPC changes&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Another issue to consider is that more biologics have entered the market over time&#44; raising expectations of effectiveness&#46; This situation may be leading to more treatment suspensions in recent years&#44; as patients are switched to another drug&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Drug costs also change over time&#44; possibly affecting the survival of drugs used to treat psoriasis&#46; Since the world economic crisis began in 2008&#44; the Spanish national health service has tried to reduce spending on expensive therapies<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">15</span></a> through measures like requiring prescriptions&#44; extending the time a patient is kept on certain drugs even if response is not optimal&#44; or promoting intermittent use or switches to cheaper medications&#46; All such changes distort drug survival analyses&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Yet another problem with drug survival studies is that the reasons for treatment interruption include both positive outcomes &#40;such as remission&#41; and negative ones &#40;such as adverse events or lack of effectiveness&#41;&#46; We also see a nonnegligible number of reasons for stopping treatment that do not fit into either of these categories and that are difficult to interpret&#46; Some 15&#37; of cases in the Biobadaderm registry involve such reasons&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> Some drug survival studies group all reasons for suspension together&#44; making their findings even more difficult to grasp and compare&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Finally&#44; a more general criticism of drug survival analysis in psoriasis concerns the very research question being asked in these studies&#58; Is it truly important for patients and clinicians to know which treatments survive longer&#63; What is really important is which treatments are more effective or safer&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">In summary&#44; we believe that drug survival studies do not offer a good way to evaluate the safety or effectiveness of psoriasis treatments and that they are particularly inappropriate for comparing treatments&#46; In a recent study utilizing Biobadaderm registry data we showed that drug survival used as a proxy indicator of safety was misleading&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> The best way to measure safety&#44; we think&#44; is to publish the rates of adverse events in cohort studies&#46; Effectiveness is best demonstrated through experimental or observational studies in which effectiveness is specified as the outcome measure&#46; Drug survival analysis&#44; with all its inherent problems&#44; may be of interest mainly for generating models to assess treatment cost&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">P&#46; D&#225;vila-Seijo has received grants from Pfizer and Janssen to attend conferences&#46; I&#46; Garc&#237;a-Doval has received grants from Pfizer&#44; Janssen&#44; and Merck&#47;Schering-Plough Pharmaceuticals to attend conferences&#46;</p></span></span>"
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                            2 => "L&#46;E&#46; Bryld"
                            3 => "L&#46; Iversen"
                            4 => "S&#46; Lasthein"
                            5 => "L&#46; Skov"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
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                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2014"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "6"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Survival rate of antitumour necrosis factor-&#945; treatments for psoriasis in routine dermatological practice&#58; A multicentre observational study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Esposito"
                            1 => "P&#46; Gisondi"
                            2 => "N&#46; Cassano"
                            3 => "G&#46; Ferrucci"
                            4 => "M&#46; del Giglio"
                            5 => "F&#46; Loconsole"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/bjd.12422"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2013"
                        "volumen" => "169"
                        "paginaInicial" => "666"
                        "paginaFinal" => "672"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23647206"
                            "web" => "Medline"
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                      ]
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                  ]
                ]
              ]
            ]
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              "identificador" => "bib0115"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#8220;Happy&#8221; drug survival of adalimumab&#44; etanercept and ustekinumab in psoriasis in daily practice care&#58; Results from the BioCAPTURE network"
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                        0 => array:2 [
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                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Van den Reek"
                            1 => "J&#46; Zweegers"
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                            3 => "M&#46;E&#46; Otero"
                            4 => "P&#46;P&#46; van Lumig"
                            5 => "R&#46;J&#46; Driessen"
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                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/bjd.13087"
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                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2014"
                        "volumen" => "171"
                        "paginaInicial" => "1189"
                        "paginaFinal" => "1196"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24807471"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0120"
              "etiqueta" => "8"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Drug survival rates of biologic treatments in patients with psoriasis vulgaris"
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                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;M&#46; Brunasso"
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                            2 => "C&#46; Massone"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2133.2011.10557.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2012"
                        "volumen" => "166"
                        "paginaInicial" => "447"
                        "paginaFinal" => "449"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21801162"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Continuous versus intermittent therapy for moderate-to-severe psoriasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;K&#46; Ramirez-Fort"
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                            2 => "S&#46;C&#46; Au"
                            3 => "A&#46;B&#46; Gottlieb"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Rheumatol"
                        "fecha" => "2013"
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                        "paginaInicial" => "S63"
                        "paginaFinal" => "S70"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24129141"
                            "web" => "Medline"
                          ]
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                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "10"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A randomized comparison of continuous vs intermittent infliximab maintenance regimens over 1 year in the treatment of moderate-to-severe plaque psoriasis"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Menter"
                            1 => "S&#46;R&#46; Feldman"
                            2 => "G&#46;D&#46; Weinstein"
                            3 => "K&#46; Papp"
                            4 => "R&#46; Evans"
                            5 => "C&#46; Guzzo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2007"
                        "volumen" => "56"
                        "paginaInicial" => "31e1"
                        "paginaFinal" => "31e15"
                      ]
                    ]
                  ]
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              ]
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              "etiqueta" => "11"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Efficacy and safety of infliximab as continuous or intermittent therapy in patients with moderate-to-severe plaque psoriasis&#58; Results of a randomized&#44; long-term extension trial &#40;RESTORE2&#41;"
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                        0 => array:2 [
                          "etal" => false
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                            2 => "H&#46; Zheng"
                            3 => "H&#46;J&#46; van Hoogstraten"
                            4 => "L&#46; Flint"
                            5 => "J&#46; Barker"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
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                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2013"
                        "volumen" => "168"
                        "paginaInicial" => "1325"
                        "paginaFinal" => "1334"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23621698"
                            "web" => "Medline"
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                  ]
                ]
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            ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Change in the discontinuation pattern of tumour necrosis factor antagonists in rheumatoid arthritis over 10 years&#58; Data from the Spanish registry BIOBADASER 2&#46;0"
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                        0 => array:2 [
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                            2 => "C&#46; Campos-Fern&#225;ndez"
                            3 => "M&#46; Montoro"
                            4 => "M&#46;A&#46; Descalzo"
                            5 => "L&#46; Carmona"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/annrheumdis-2011-200302"
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                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2012"
                        "volumen" => "71"
                        "paginaInicial" => "382"
                        "paginaFinal" => "385"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21998116"
                            "web" => "Medline"
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                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
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                0 => array:1 [
                  "referenciaCompleta" => "European Medicines Agency&#46; Embrel&#58; EPAR-Scientific discussion&#46; 2006&#46;"
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              "identificador" => "bib0150"
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                  "referenciaCompleta" => "European Medicines Agency&#46; Embrel&#58; EPAR-Product information&#46; 2009&#46;"
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                    0 => array:2 [
                      "titulo" => "Efectos de la crisis econ&#243;mica y de la crisis de trabajadores sanitarios en la sostenibilidad del sistema sanitario&#58; &#191;qu&#233; es lo siguiente&#63;"
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                        "tituloSerie" => "Enferm Clin"
                        "fecha" => "2012"
                        "volumen" => "22"
                        "paginaInicial" => "179"
                        "paginaFinal" => "181"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22920676"
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                      ]
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                  ]
                ]
              ]
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                          "etal" => true
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                        "tituloSerie" => "J Eur Acad Dermatol Venereol"
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ISSN: 15782190
Original language: English
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Idiomas
Actas Dermo-Sifiliográficas
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