Skin Clearance is Associated with Reduced Treatment Failure in Patients with Psoriasis: Real-World Evidence from the CorEvitas Psoriasis Registry
Abstract Introduction Complete and near-complete skin clearance have become achievable treatment goals for patients with psoriasis receiving systemic biologic therapies. However, there is limited real-world evidence regarding the impact of the degree of skin clearance on biologic treatment patterns...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2023-09-01
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| Series: | Dermatology and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s13555-023-01027-6 |
| _version_ | 1797647440456712192 |
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| author | Robert R. McLean Adam P. Sima Silky Beaty Robert Low Rebecca L. Spitzer Jeffrey L. Stark Elizabeth Lesser Edward Lee April Armstrong |
| author_facet | Robert R. McLean Adam P. Sima Silky Beaty Robert Low Rebecca L. Spitzer Jeffrey L. Stark Elizabeth Lesser Edward Lee April Armstrong |
| author_sort | Robert R. McLean |
| collection | DOAJ |
| description | Abstract Introduction Complete and near-complete skin clearance have become achievable treatment goals for patients with psoriasis receiving systemic biologic therapies. However, there is limited real-world evidence regarding the impact of the degree of skin clearance on biologic treatment patterns among these patients. Methods This longitudinal cohort study assessed the relationship between degree of skin clearance following initiation of a systemic biologic therapy and treatment failure among patients from the CorEvitas Psoriasis Registry (April 2015–August 2021). Patients had Psoriasis Area and Severity Index (PASI) score > 5 at systemic biologic therapy initiation and ≥ 1 follow-up visit(s) within 15 months of initiation. Treatment failure (discontinuation due to poor response/adverse event; addition of non-biologic therapy) and degree of skin clearance (measured by PASI) were assessed following biologic initiation. Proportional hazards regression was used to estimate the association between PASI response level and treatment failure over follow-up. Results This study included 2701 patient initiations from 2516 unique patients with 3846 total visits over follow-up. Over half of the patient initiations (n = 1412; 52.3%) were among patients with PASI >10. Treatment failure occurred in 1.3% of visits at which PASI100 was achieved, while those achieving PASI90 – < 100 and PASI75 – < 90 had treatment failure rates of 3.4% and 3.5%, respectively. After adjustment for confounders, the risk of treatment failure was two to three times higher in the PASI90 – < 100 (hazard ratio [HR] = 2.61; 95% confidence interval [CI] 1.35, 5.02; p = 0.004) and PASI75 < 90 (HR = 2.97; CI 1.58, 5.58; p = 0.001) groups compared to the PASI100 group. The risk of treatment failure was more than 20 times higher in the < PASI75 group versus the PASI100 group (HR = 22.26; CI 13.32, 37.21; p < 0.001). Conclusions The results suggest that patients are more likely to remain on a systemic biologic therapy if they achieve near-complete or complete skin clearance, supporting the continued need to target skin clearance as a treatment goal in psoriasis. Trial Registration ClinicalTrials.gov identifier, NCT02707341. |
| first_indexed | 2024-03-11T15:16:21Z |
| format | Article |
| id | doaj.art-f97a71f5efb648caa6cc8cca86a89526 |
| institution | Directory Open Access Journal |
| issn | 2193-8210 2190-9172 |
| language | English |
| last_indexed | 2024-03-11T15:16:21Z |
| publishDate | 2023-09-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Dermatology and Therapy |
| spelling | doaj.art-f97a71f5efb648caa6cc8cca86a895262023-10-29T12:15:15ZengAdis, Springer HealthcareDermatology and Therapy2193-82102190-91722023-09-0113112739275110.1007/s13555-023-01027-6Skin Clearance is Associated with Reduced Treatment Failure in Patients with Psoriasis: Real-World Evidence from the CorEvitas Psoriasis RegistryRobert R. McLean0Adam P. Sima1Silky Beaty2Robert Low3Rebecca L. Spitzer4Jeffrey L. Stark5Elizabeth Lesser6Edward Lee7April Armstrong8CorEvitas, LLCCorEvitas, LLCUCB PharmaUCB PharmaCorEvitas, LLCUCB PharmaCorEvitas, LLCUCB PharmaKeck School of Medicine at the University of Southern CaliforniaAbstract Introduction Complete and near-complete skin clearance have become achievable treatment goals for patients with psoriasis receiving systemic biologic therapies. However, there is limited real-world evidence regarding the impact of the degree of skin clearance on biologic treatment patterns among these patients. Methods This longitudinal cohort study assessed the relationship between degree of skin clearance following initiation of a systemic biologic therapy and treatment failure among patients from the CorEvitas Psoriasis Registry (April 2015–August 2021). Patients had Psoriasis Area and Severity Index (PASI) score > 5 at systemic biologic therapy initiation and ≥ 1 follow-up visit(s) within 15 months of initiation. Treatment failure (discontinuation due to poor response/adverse event; addition of non-biologic therapy) and degree of skin clearance (measured by PASI) were assessed following biologic initiation. Proportional hazards regression was used to estimate the association between PASI response level and treatment failure over follow-up. Results This study included 2701 patient initiations from 2516 unique patients with 3846 total visits over follow-up. Over half of the patient initiations (n = 1412; 52.3%) were among patients with PASI >10. Treatment failure occurred in 1.3% of visits at which PASI100 was achieved, while those achieving PASI90 – < 100 and PASI75 – < 90 had treatment failure rates of 3.4% and 3.5%, respectively. After adjustment for confounders, the risk of treatment failure was two to three times higher in the PASI90 – < 100 (hazard ratio [HR] = 2.61; 95% confidence interval [CI] 1.35, 5.02; p = 0.004) and PASI75 < 90 (HR = 2.97; CI 1.58, 5.58; p = 0.001) groups compared to the PASI100 group. The risk of treatment failure was more than 20 times higher in the < PASI75 group versus the PASI100 group (HR = 22.26; CI 13.32, 37.21; p < 0.001). Conclusions The results suggest that patients are more likely to remain on a systemic biologic therapy if they achieve near-complete or complete skin clearance, supporting the continued need to target skin clearance as a treatment goal in psoriasis. Trial Registration ClinicalTrials.gov identifier, NCT02707341.https://doi.org/10.1007/s13555-023-01027-6Biologic therapyCorEvitas Psoriasis RegistryPASIPsoriasisReal-world evidenceSkin clearance |
| spellingShingle | Robert R. McLean Adam P. Sima Silky Beaty Robert Low Rebecca L. Spitzer Jeffrey L. Stark Elizabeth Lesser Edward Lee April Armstrong Skin Clearance is Associated with Reduced Treatment Failure in Patients with Psoriasis: Real-World Evidence from the CorEvitas Psoriasis Registry Dermatology and Therapy Biologic therapy CorEvitas Psoriasis Registry PASI Psoriasis Real-world evidence Skin clearance |
| title | Skin Clearance is Associated with Reduced Treatment Failure in Patients with Psoriasis: Real-World Evidence from the CorEvitas Psoriasis Registry |
| title_full | Skin Clearance is Associated with Reduced Treatment Failure in Patients with Psoriasis: Real-World Evidence from the CorEvitas Psoriasis Registry |
| title_fullStr | Skin Clearance is Associated with Reduced Treatment Failure in Patients with Psoriasis: Real-World Evidence from the CorEvitas Psoriasis Registry |
| title_full_unstemmed | Skin Clearance is Associated with Reduced Treatment Failure in Patients with Psoriasis: Real-World Evidence from the CorEvitas Psoriasis Registry |
| title_short | Skin Clearance is Associated with Reduced Treatment Failure in Patients with Psoriasis: Real-World Evidence from the CorEvitas Psoriasis Registry |
| title_sort | skin clearance is associated with reduced treatment failure in patients with psoriasis real world evidence from the corevitas psoriasis registry |
| topic | Biologic therapy CorEvitas Psoriasis Registry PASI Psoriasis Real-world evidence Skin clearance |
| url | https://doi.org/10.1007/s13555-023-01027-6 |
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