Stop Reason Information
Inefficacy
- A complete stop to a therapy that is not effective
- Increases to the dose or frequency of a drug to tackle a flare or rising PASI
Adverse events
- Any adverse event causing the decision to stop the drug
- Reduction in dose where the patient was having side effects
Inefficacy and adverse events
- Any combination of the above two reasons
Remission
- The disease is in remission
- Should only be used where the treatment is stopped completely due to the patient's skin being completely clear
- Should not be used for a reduction in dose
Patient non-compliance
- Patient failing to attend clinic
- Drug delay issue related to the patient failing to attend
- Patient not taking the drug as prescribed
Titration
- Standard dosing patterns (both increases and decreases in dose) for Methotrexate, Fumaric Acid Esters, Skilarence and Ciclosporin
- End of treatment cycle for Ciclosporin
- Should only be used for Methotrexate, Fumaric Acid Esters, Skilarence and Ciclosporin – not used for dose changes in any other drug
Financial consideration
- Switching from an originator biologic to a biosimilar due to a change in trust policy
- Switching from Fumaric Acid Esters to Skilarence due to a change in trust policy
Contraindication
- Should be used when the patient stops the drug as other circumstances make the treatment inadvisable
- Examples include stopping for family planning reasons, to have a vaccination, to commence on a different immunosuppressant therapy, or stopping for surgery
Patient choice
- The patient has chosen to end the treatment and no further details are available
Clinical trial
- The patient has stopped a drug they were taking as part of a clinical trial due to the trial ending
- Should not be used when the patient stops a drug to enter onto a clinical trial
Death
- The drug was stopped because the patient passed away
- If the decision is made to stop a drug due to an adverse event that later leads to patient death, this would be classed as Adverse Events instead of Death
Other
- Should only be used when none of the other reasons are applicable
- E.g. dose reduction in non-titrating drug
- E.g. patient going on holiday