Real-World Biologic Adherence, Persistence, and Monotherapy Comparisons in US Patients with Psoriasis: Results from IBM MarketScan® Databases

Abstract

Introduction Limited real-world data are available comparing multiple biologics on their adherence, persistence, and the use of concomitant biologics in the treatment of moderate-to-severe psoriasis in clinical practice. The objective was to compare persistence of and adherence to ixekizumab (IXE) treatment, as monotherapy or with concomitant medication, versus patients receiving other commonly prescribed biologics. Methods Patients who newly initiated IXE, adalimumab (ADA), etanercept (ETN), secukinumab (SEC), or ustekinumab (UST) in IBM MarketScan ® databases with diagnosis of psoriasis were identified. Treatment comparisons on medication persistence, adherence, and monotherapy were based on balanced samples after inverse probability of treatment weighting (IPTW). Results A higher proportion of patients receiving IXE had had previous biologic therapies (50.3%) versus other biologics (ADA: 9.1%, ETN: 10.9%, SEC: 33.9%, UST: 19.7%). Patients treated with IXE showed statistically ( p < 0.001) greater persistence than patients treated with SEC, ADA, UST, or ETN at both 1-year follow-up and up to 3 years of follow-up. Adherence for patients treated with IXE was significantly ( p < 0.001) higher compared to ADA, ETN, and UST at both 1-year follow-up and up to 3 years of follow-up. There was no significantly higher adherence in patients treated with IXE compared to those treated with SEC at 1-year follow-up, but IXE had higher adherence than SEC ( p < 0.05) at 1–3 year follow-up. IXE showed longer time on monotherapy than ADA ( p < 0.001), ETN ( p < 0.001), SEC ( p < 0.05), and UST ( p < 0.001) for both 1-year and 1–3 year follow-up. Sensitivity analyses on persistence, adherence, and monotherapy with further model adjustments after IPTW confirmed the findings. Conclusions Patients treated with IXE were more persistent on and adherent to treatment and remained on monotherapy longer compared to those on all other commonly prescribed biologics combined or with individual biologics. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-022-02155-9.

Blocking interleukin‐17 in psoriasis: Real‐world experience from the PsoPlus cohort

“…Accordingly, multiple (inter)national registries reported longer drug survival of IXE as well, followed by SEC survival, and -where applicable -lastly BRO. [18][19][20][53][54][55][56] Next, bio-naive IL-17i patients in our cohort demonstrated prolonged drug survival of approximately 10 months compared to bio-experienced patients (55.7 vs. 45.8 months, respectively), when pooled for all IL-17i. Similarly, bioexperience was related to shorter drug survival in other registries as well.…”

“…Still, IXE tended to have a higher survival, followed closely by SEC in the short term. Accordingly, multiple (inter)national registries reported longer drug survival of IXE as well, followed by SEC survival, and – where applicable – lastly BRO 18–20,53–56 …”

Healthcare Costs Among Patients with Psoriasis Treated with Ixekizumab Versus Secukinumab in Real-World Settings Over 24 Months

“…After adjusting for both ICER discounts and adherence, differences in mean index drug costs PPPM between IXE and SEC users declined from US$596 (US$3990 vs US$3394) to US$28 (US$3794 vs US$3766). This highlights the added benefits of higher treatment adherence among IXE users as both treatments are equally expensive and no significant differences in ICER-adjusted all-cause and psoriasis-related costs between IXE and SEC were observed [ 20 , 21 ].…”

Outcomes of Biologic Use in Asian Compared with Non-Hispanic White Adult Psoriasis Patients from the CorEvitas Psoriasis Registry

“…The advent of biologic agents over nearly two decades has dramatically enhanced the treatment of moderate to severe psoriasis. Data from randomized controlled trials (RCTs) [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] have demonstrated that these agents can be highly efficacious. Yet the preponderance of evidence has been garnered from studies that have primarily included White patients.…”

“…However, while prior real-world evidence (RWE) studies have demonstrated the effectiveness of biologic therapies for psoriasis [4][5][6][7][8][9][10][11][12][13][14][15][16], there is little published data comparing the efficacy of biologics in Asian compared with other ethnicities in RWE studies. Real-world evidence is essential for providing insight into the efficacy and safety of drug treatments across all patients with psoriasis since the typical strict inclusion criteria of RCTs often exclude many patient populations seen in routine clinical care, including those with multiple comorbidities, ethnic and racial subpopulations, older adults, and patients for whom multiple biologics have failed.…”