Patterns of Medication Utilization and Costs Associated with the Use of Etanercept, Adalimumab, and Ustekinumab in the Management of Moderate-to-Severe Psoriasis

Feldman, Steven R.; Zhao, Yang; Navaratnam, Prakash; Frıedman, Howard S.; Lu, Jackie; Tran, Mary Helen

doi:10.18553/jmcp.2015.21.3.201

Cited by 56 publications

(79 citation statements)

References 31 publications

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“…Results based on retrospective cohort analyses using administrative databases or claims were published in 10 articles (15%), most of them in recent years (90% since 2014), and included data from large populations (more than 12,000 patients). These analyses were mainly conducted in the US population using data from various health claims [35, 36, 40-44], including Medicare Database. Three publications were based on European (Italy and Sweden) [45, 46] and Israeli populations [28].…”

Section: Resultsmentioning

confidence: 99%

“…Clinical outcomes (mainly PASI) were reported in 75% of prospective studies [27, 39, 47-53], in about 50% of prospective registries [20, 24, 54-61] and retrospective studies [29, 30, 32, 34, 37, 62-70], and in no retrospective administrative databases/claims. Drug survival of biological therapies was reported in over 60% of prospective registries [14, 20, 21, 24, 25, 31, 54, 57, 71-74], retrospective studies [18, 19, 22, 23, 26, 29, 30, 32, 34, 37, 38, 68, 70, 75-77] and administrative databases/claims [28, 35, 36, 40-42, 46], and less frequently (33%) in prospective studies [27, 33, 52, 78]. Subanalyses on reasons of discontinuation, such as switching, dose augmentation, or biological therapy restarting, were scanty.…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness End Points in Real-World Studies on Biological Therapies in Psoriasis: Systematic Review with Focus on Drug Survival

Costanzo¹,

Malara²,

Pelucchi³

et al. 2018

Dermatology

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Psoriasis is a complex and chronic disease, and, in most cases, therapies are required during all patients’ lifetime. The efficacy and safety profiles of biological therapies are well established, but their effectiveness is still open to discussion. We performed a systematic review to summarize how the effectiveness of biological therapies for psoriasis is measured in real-world studies and to understand whether drug survival, a recent alternative outcome to clinical ones, is a recurrent and valid outcome of effectiveness. In March 2017, we searched for quantitative epidemiological data of psoriasis treatments using PubMed/Medline and EMBASE, and we included 65 publications. The retrospective study design (37%) was most frequent, followed by prospective registries (29%), prospective studies (19%), and retrospective administrative databases/claims. Drug survival was reported in over 60% of prospective registries and retrospective studies, and less frequently in prospective studies. A general consensus emerged in the definition of drug survival as the time patients remain under treatment with a specific therapy, and in its interpretation as an overall marker of treatment success and treatment adherence, as it represents simultaneously information on drug efficacy, drug safety, and patient satisfaction. In conclusion, notwithstanding some limitations, drug survival is a useful measurement of biological therapy effectiveness for psoriasis in daily practice. Its major advantage is that it can be computed also in already collected databases without any specific clinical information on psoriasis. This outcome, combined with evidence on clinical markers of effectiveness, can contribute to better understanding the performance of this expensive class of drugs.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Effectiveness End Points in Real-World Studies on Biological Therapies in Psoriasis: Systematic Review with Focus on Drug Survival

Costanzo¹,

Malara²,

Pelucchi³

et al. 2018

Dermatology

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“…Approximately one-third of patients had their doses increased until month 6 and 39% until month 12 of treatment. On the other hand, half of these patients also discontinued the biologic drug or reduced the dose [6]. This indicates that many patients do not achieve suicient response or lose an initially favourable response over time.…”

Section: Genesmentioning

confidence: 99%

“…Systemic inlammation is also one of the reasons for the occurrence of many other comorbidities in patients with psoriasis, such as metabolic syndrome which includes obesity, type 2 diabetes, hypertension and dyslipidaemia, cardiovascular diseases, chronic inlammatory bowel disease and also cancer in some cases [4]. Furthermore, lower quality of life and psychological disorders are also more frequent among psoriasis patients as compared to general population [5,6]. It is proven that lifestyle, including diet, smoking and alcohol consumption, inluences the occurrence and the course of psoriasis and the comorbidities [7].…”

Section: Introductionmentioning

confidence: 99%

“…The patient's response to systemic psoriasis treatment cannot be predicted. Furthermore, the interindividual variability in the treatment response is quite extensive and adverse events occur frequently [6]. A study conducted 3 years ago discovered that approximately 75% of traditional systemic drugs are discontinued after 143 days of treatment (p < 0.0001), mostly because of adverse events (p < 0.001) [8].…”

Section: Introductionmentioning

confidence: 99%

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Pharmacogenetics of Psoriasis Treatment

Redenšek¹,

Dolžan²

2017

An Interdisciplinary Approach to Psoriasis

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Psoriasis is a chronic systemic, immune-mediated disorder of unknown aetiology, usually presenting with typical inlammatory skin lesions and/or joint manifestations, but systemic inlammation that may lead to the development of co-morbidities may also be present. First-line therapy encompasses local cutaneous treatment and phototherapy, but with more severe symptoms or systemic course, systemic treatment with methotrexate (MTX), immunosuppressant cyclosporine, retinoid acitretin or biologicals may be used. Treatment response varies between patients in terms of eicacy and/or toxicity, which could, among other reasons, be due to genetic diferences between patients. Approximately 10-30% of patients experience adverse drug reactions with MTX treatment, leading to discontinuation of MTX mostly due to hepatotoxicity. Around 15% of patients experience adverse events when treated with biologicals; however, the most frequent reason for discontinuation is ineicacy or loss of the initially favourable response over time. Ineicacy or occurrence of adverse drug reactions cannot be predicted, so genetic biomarkers of drug response in combination with clinical data could be helpful in treatment planning. Several polymorphic genes have already been associated with treatment outcome, most of them involved in drug metabolism, transport and target pathways. Genetic biomarkers could be helpful in personalized care of psoriasis patients in order to prevent adverse events or predict ineicacy of a certain drug.

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Medication persistence of targeted immunomodulators for plaque psoriasis: A retrospective analysis using a U.S. claims database

Hendrix

Marcum

Veenstra

2020

Pharmacoepidemiology and Drug

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Purpose Studies of medication persistence in plaque psoriasis have shown inconsistent results, likely due to differing definitions of nonpersistence and of the permissible gap between refills. Also, medication persistence information for two recently approved drugs, apremilast and ixekizumab, is limited. Methods We use the Truven Health MarketScan claims database to assess persistence for six drugs: adalimumab, apremilast, etanercept, ixekizumab, secukinumab, and ustekinumab. We define the permissible gap in three ways: 150 days for ustekinumab and 90 days for all other drugs (150/90 model); 120 days for all drugs (120 model); and twice the days' supply for all drugs (days' supply model). To estimate unadjusted persistence, we use Kaplan‐Meier curves, and a proportional hazards model to estimate the adjusted risk of non‐persistence. Results Ustekinumab is most sensitive to changes in the definition of permissible gap, likely because of its longer maintenance dosing interval. Among targeted drug‐experienced patients using ustekinumab, median persistence is 358 days (95% confidence interval: 343‐371) in the 150/90 model and 189 days (179‐199) in the days' supply model. Among targeted drug‐experienced patients, median persistence in the days' supply model is longest for ixekizumab and secukinumab at 252 (217‐301) and 222 (210‐244) days, respectively. We also find that adjusted risk of nonpersistence increases by approximately 1% per year at treatment start. Conclusion The definition of permissible gap meaningfully changes both absolute and ordinal estimates of medication persistence. Each definition has unique limitations, which should be considered when interpreting persistence data.

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Patterns of Medication Utilization and Costs Associated with the Use of Etanercept, Adalimumab, and Ustekinumab in the Management of Moderate-to-Severe Psoriasis

Abstract: BACKGROUND: Dose escalations of biologic agents may be attempted in the management of moderate-to-severe psoriasis. This has implications for the real-world cost of treatment.

Cited by 56 publications

References 31 publications

Effectiveness End Points in Real-World Studies on Biological Therapies in Psoriasis: Systematic Review with Focus on Drug Survival

Effectiveness End Points in Real-World Studies on Biological Therapies in Psoriasis: Systematic Review with Focus on Drug Survival

Pharmacogenetics of Psoriasis Treatment

Medication persistence of targeted immunomodulators for plaque psoriasis: A retrospective analysis using a U.S. claims database

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