Long-Term Psoriasis Control with Guselkumab, Adalimumab, Secukinumab, or Ixekizumab in the USA
Abstract Background Biologics have revolutionized the management of psoriasis, but response to treatment varies. Loss of treatment efficacy may occur over time, requiring treatment switching or escalation. Claims data on persistence may be informative of real-world treatment outcome. This analysis d...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2023-03-01
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| Series: | Dermatology and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s13555-023-00910-6 |
| _version_ | 1797578059593809920 |
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| author | Timothy Fitzgerald Maryia Zhdanava Dominic Pilon Aditi Shah Annalise Hilts Patrick Lefebvre Steven R. Feldman |
| author_facet | Timothy Fitzgerald Maryia Zhdanava Dominic Pilon Aditi Shah Annalise Hilts Patrick Lefebvre Steven R. Feldman |
| author_sort | Timothy Fitzgerald |
| collection | DOAJ |
| description | Abstract Background Biologics have revolutionized the management of psoriasis, but response to treatment varies. Loss of treatment efficacy may occur over time, requiring treatment switching or escalation. Claims data on persistence may be informative of real-world treatment outcome. This analysis described persistence and rates of remission of patients with psoriasis initiated on current biologics. Methods Adults with psoriasis initiated (index date) on guselkumab, adalimumab, secukinumab, or ixekizumab between 07/13/2017 and 07/31/2020 were identified in the IBM MarketScan Databases. Discontinuation (or end of persistence) was defined as gaps in index biologic supply of more than twice the labelled dosing interval or mode days of supply (> 120 days for guselkumab and > 60 days for adalimumab, secukinumab, and ixekizumab). The proportion of patients reinitiating index therapy post-discontinuation and the proportion achieving remission (proxy definition: no claims for psoriasis-related treatment post-discontinuation among patients with ≥ 6 months of follow-up post-discontinuation) were assessed. Results There were 3408 patients in the guselkumab (mean age: 47.9 years old; female: 47.1%), 8017 in the adalimumab (47.4 years old; 54.1%), 6123 in the secukinumab (49.4 years old; 54.2%), and 3728 in the ixekizumab cohorts (49.1 years old; 50.3%). The median time to discontinuation was 26.2 months in the guselkumab cohort and 9.9, 12.4, and 12.5 months in adalimumab, secukinumab, and ixekizumab cohorts, respectively. Among those who discontinued index therapy, 22.9% in the guselkumab cohort and 21.1%, 31.9%, and 32.0% in the adalimumab, secukinumab, and ixekizumab cohorts reinitiated it. Remission rates were 17.2% in the guselkumab cohort and 12.4%, 10.5%, and 9.0% in adalimumab, secukinumab, and ixekizumab cohorts, respectively. Conclusions Patients on guselkumab showed trends toward better persistence and higher remission rates relative to other biologics. Finding patients who may be in remission suggests potential disease modification with current agents. |
| first_indexed | 2024-03-10T22:16:53Z |
| format | Article |
| id | doaj.art-ed0c182cb61f465986a7c7bda8397a75 |
| institution | Directory Open Access Journal |
| issn | 2193-8210 2190-9172 |
| language | English |
| last_indexed | 2024-03-10T22:16:53Z |
| publishDate | 2023-03-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Dermatology and Therapy |
| spelling | doaj.art-ed0c182cb61f465986a7c7bda8397a752023-11-19T12:25:48ZengAdis, Springer HealthcareDermatology and Therapy2193-82102190-91722023-03-011341053106810.1007/s13555-023-00910-6Long-Term Psoriasis Control with Guselkumab, Adalimumab, Secukinumab, or Ixekizumab in the USATimothy Fitzgerald0Maryia Zhdanava1Dominic Pilon2Aditi Shah3Annalise Hilts4Patrick Lefebvre5Steven R. Feldman6Janssen Scientific Affairs, LLC.Groupe d’AnalyseGroupe d’AnalyseGroupe d’AnalyseGroupe d’AnalyseGroupe d’AnalyseWake Forest University School of MedicineAbstract Background Biologics have revolutionized the management of psoriasis, but response to treatment varies. Loss of treatment efficacy may occur over time, requiring treatment switching or escalation. Claims data on persistence may be informative of real-world treatment outcome. This analysis described persistence and rates of remission of patients with psoriasis initiated on current biologics. Methods Adults with psoriasis initiated (index date) on guselkumab, adalimumab, secukinumab, or ixekizumab between 07/13/2017 and 07/31/2020 were identified in the IBM MarketScan Databases. Discontinuation (or end of persistence) was defined as gaps in index biologic supply of more than twice the labelled dosing interval or mode days of supply (> 120 days for guselkumab and > 60 days for adalimumab, secukinumab, and ixekizumab). The proportion of patients reinitiating index therapy post-discontinuation and the proportion achieving remission (proxy definition: no claims for psoriasis-related treatment post-discontinuation among patients with ≥ 6 months of follow-up post-discontinuation) were assessed. Results There were 3408 patients in the guselkumab (mean age: 47.9 years old; female: 47.1%), 8017 in the adalimumab (47.4 years old; 54.1%), 6123 in the secukinumab (49.4 years old; 54.2%), and 3728 in the ixekizumab cohorts (49.1 years old; 50.3%). The median time to discontinuation was 26.2 months in the guselkumab cohort and 9.9, 12.4, and 12.5 months in adalimumab, secukinumab, and ixekizumab cohorts, respectively. Among those who discontinued index therapy, 22.9% in the guselkumab cohort and 21.1%, 31.9%, and 32.0% in the adalimumab, secukinumab, and ixekizumab cohorts reinitiated it. Remission rates were 17.2% in the guselkumab cohort and 12.4%, 10.5%, and 9.0% in adalimumab, secukinumab, and ixekizumab cohorts, respectively. Conclusions Patients on guselkumab showed trends toward better persistence and higher remission rates relative to other biologics. Finding patients who may be in remission suggests potential disease modification with current agents.https://doi.org/10.1007/s13555-023-00910-6BiologicsGuselkumabPersistencePsoriasisRemissionTreatment discontinuation |
| spellingShingle | Timothy Fitzgerald Maryia Zhdanava Dominic Pilon Aditi Shah Annalise Hilts Patrick Lefebvre Steven R. Feldman Long-Term Psoriasis Control with Guselkumab, Adalimumab, Secukinumab, or Ixekizumab in the USA Dermatology and Therapy Biologics Guselkumab Persistence Psoriasis Remission Treatment discontinuation |
| title | Long-Term Psoriasis Control with Guselkumab, Adalimumab, Secukinumab, or Ixekizumab in the USA |
| title_full | Long-Term Psoriasis Control with Guselkumab, Adalimumab, Secukinumab, or Ixekizumab in the USA |
| title_fullStr | Long-Term Psoriasis Control with Guselkumab, Adalimumab, Secukinumab, or Ixekizumab in the USA |
| title_full_unstemmed | Long-Term Psoriasis Control with Guselkumab, Adalimumab, Secukinumab, or Ixekizumab in the USA |
| title_short | Long-Term Psoriasis Control with Guselkumab, Adalimumab, Secukinumab, or Ixekizumab in the USA |
| title_sort | long term psoriasis control with guselkumab adalimumab secukinumab or ixekizumab in the usa |
| topic | Biologics Guselkumab Persistence Psoriasis Remission Treatment discontinuation |
| url | https://doi.org/10.1007/s13555-023-00910-6 |
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