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Abstract Number: 1520

Long-Term Treatment Patterns of Biologics and Apremilast Among Patients with Moderate-to-Severe Plaque Psoriasis by Psoriatic Arthritis Status

Steven Feldman 1, Jingchuan Zhang2, Diane Martinez 3, Lorena Lopez-Gonzalez 3, Elizabeth Holt Marchlewicz 3, George Shrady 3, Alan Mendelsohn 4 and Yang zhao 5, 1Wake Forest Baptist Health, Winston-Salem, NC, 2Sun Pharmaceutical Industries, Princeton, NJ, 3IBM Watson Health, Washington, DC, 4Sun Pharmaceutical Industries, Inc., Princeton, NJ, USA, Princeton, NJ, 5Sun Pharmaceutical Industries, Princeton

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Biologics, data analysis and drug treatment, psoriasis, Psoriatic arthritis

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Session Information

Date: Monday, November 11, 2019

Session Title: Spondyloarthritis Including Psoriatic Arthritis – Clinical Poster II: Treatment of Axial Spondyloarthritis & Psoriatic Arthritis

Session Type: Poster Session (Monday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Long-term real-world treatment patterns of psoriasis patients are not well characterized, especially those with comorbid psoriatic arthritis (PsA). This study examined the treatment patterns among psoriasis patients who newly initiated a biologic or apremilast (APR) by PsA status.

Methods: Using a large US claims database, adult patients with psoriasis were classified into 5 mutually exclusive cohorts based on their initial index medication between 01/01/2015 and 08/31/2018: secukinumab (SEC), adalimumab (ADA), ustekinumab (UST), etanercept (ETA), or APR. Eligible patients had no index medication use in the 12-month pre-index period, and had continuous medical and pharmacy benefits in the 12-month pre-index and 24-month post-index periods. Subgroups were created by the presence of a PsA diagnosis over the 12-month pre-index period. Rates of discontinuation, adherence (proportion of days covered [PDC], adherent if PDC ≥0.8), non-persistence, and switching were compared between patients with and without PsA within each cohort. Treatment gaps were defined as 4 weeks for ETA and APR, 8 weeks for ADA, 10 weeks for SEC, and 18 weeks for UST.

Results: A total of 7,773 psoriasis patients were included: 275, 2,684, 910, 1,063, and 2,841 patients for SEC, ADA, UST, ETA, and APR, respectively, and the proportions of patients with PsA were 35.3%, 35.1%, 22.0%, 45.7%, and 24.8%, respectively. Over the 24-month post-index period, discontinuation rates for patients with and without PsA were: SEC: 54.6% vs. 43.8%; ADA: 48.3% vs. 53.0%; UST: 52.5% vs. 34.4%; ETA: 38.1% vs. 45.4%; and APR: 47.7% vs. 43.4% (all p< 0.05 except SEC). Adherence rates were: SEC: 30.9% vs. 34.8%; ADA*: 30% vs. 25.5%; UST: 17.5% vs. 23.9%; ETA*: 26.5% vs. 16.8%; and APR: 22.4% vs. 22.9% (*p< 0.05). Non-persistence rates were: SEC: 69.1% vs. 65.7%; ADA: 71% vs. 74.4%; UST*: 68.5% vs. 55.5%; ETA*: 82.1% vs. 90.3%; and APR: 86.6% vs. 84.8% (*p< 0.05). Overall switching rates were high for all groups (24.8%–55.1%, all p< 0.05 except ETA).

Conclusion: About 22%–46% moderate-to-severe psoriasis patients who initiated biologics or APR had comorbid PsA. Over 24-month post-index period, overall adherence was poor and discontinuation, non-persistence, and switching were high for all groups. Maintaining long-term therapy is still a challenge for psoriasis patients. Treatments that overcome the hurdle of poor adherence to self-administration may be helpful.


Disclosure: S. Feldman, Abbvie, 2, 8, Alvotech, 8, Advance Medical, 8, Caremark, 8, Causa Technologies, 4, Celgene, 2, 8, Informa, 7, Galderma Laboratories, L.P., 2, 8, Gerson Lehrman Group, 8, Guidepoint Global, 8, Janssen, 2, 8, Kikaku, 8, Leo Pharma, Inc., 8; J. Zhang, Sun Pharmaceutical Industries, 3; D. Martinez, Sun Pharmaceutical Industries, 5; L. Lopez-Gonzalez, Sun Pharmaceutical Industries, 5; E. Marchlewicz, Sun Pharmaceutical Industries, 5; G. Shrady, Sun Pharmaceutical Industries, 5; A. Mendelsohn, Johnson and Johnson, 1, 4, Sun Pharmaceutical Industries, Inc, 3, Sun Pharmaceutical Industries, Inc., 3; Y. zhao, Sun Pharmaceutical Industries, 3.

To cite this abstract in AMA style:

Feldman S, Zhang J, Martinez D, Lopez-Gonzalez L, Marchlewicz E, Shrady G, Mendelsohn A, zhao Y. Long-Term Treatment Patterns of Biologics and Apremilast Among Patients with Moderate-to-Severe Plaque Psoriasis by Psoriatic Arthritis Status [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/long-term-treatment-patterns-of-biologics-and-apremilast-among-patients-with-moderate-to-severe-plaque-psoriasis-by-psoriatic-arthritis-status/. Accessed February 3, 2023.
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