Persistence of Biologic Treatments in Psoriatic Arthritis: a Population-based Study in Sweden

Overview

Journal Rheumatol Adv Pract

Publisher Oxford University Press

Specialty Rheumatology

Date 2021 Jan 7

PMID 33409449

Citations 18

Authors

Kirk Geale

Ingrid Lindberg

Emma C Paulsson

E Christina M Wennerstrom

Anna Tjarnlund

Wim Noel

Dana Enkusson

Elke Theander

Affiliations

Soon will be listed here.

Abstract

Objectives: TNF inhibitors (TNFis) and IL inhibitors are effective treatments for PsA. Treatment non-persistence (drug survival, discontinuation) is a measure of effectiveness, tolerability and patient satisfaction or preferences in real-world clinical practice. Persistence on these treatments is not well understood in European PsA populations. The aim of this study was to compare time to non-persistence for either ustekinumab (IL-12/23 inhibitor) or secukinumab (IL-17 inhibitor) to a reference group of adalimumab (TNFi) treatment exposures in PsA patients and identify risk factors for non-persistence.

Methods: A total of 4649 exposures of adalimumab, ustekinumab, and secukinumab in 3918 PsA patients were identified in Swedish longitudinal population-based registry data. Kaplan-Meier curves were constructed to measure treatment-specific real-world risk of non-persistence and adjusted Cox proportional hazards models were estimated to identify risk factors associated with non-persistence.

Results: Ustekinumab was associated with a lower risk of non-persistence relative to adalimumab in biologic-naïve [hazard ratio (HR) 0.48 (95% CI 0.33, 0.69)] and biologic-experienced patients [HR 0.65 (95% CI 0.56, 0.76)], while secukinumab was associated with a lower risk in biologic-naïve patients [HR 0.65 (95% CI 0.49, 0.86)] but a higher risk of non-persistence in biologic-experienced patients [HR 1.20 (95% CI 1.03, 1.40)]. Biologic non-persistence was also associated with female sex, axial involvement, recent disease onset, biologic treatment experience and no psoriasis.

Conclusion: Ustekinumab exhibits a favourable treatment persistency profile relative to adalimumab overall and across lines of treatment. The performance of secukinumab is dependent on biologic experience. Persistence and risk factors for non-persistence should be accounted for when determining an optimal treatment plan for patients.

Citing Articles

Sustained response to guselkumab regardless of baseline characteristics in patients with active psoriatic arthritis and inadequate response to TNF inhibitors: results from the phase 3b COSMOS clinical trial.

McInnes I, Sewerin P, Sharaf M, Efficace M, Lavie F, Zimmermann M RMD Open. 2024; 10(4.

PMID: 39672591 PMC: 11647317. DOI: 10.1136/rmdopen-2024-004494.

Drug Survival, Retention, and Persistence of Dupilumab in Adults and Adolescents with Atopic Dermatitis: A Narrative Literature Review.

Rossi M, Ferrucci S, Calzavara-Pinton P, Marzano A, Peris K, Nicoli E Adv Ther. 2024; 42(1):94-105.

PMID: 39546252 PMC: 11782415. DOI: 10.1007/s12325-024-03052-z.

Comparison of Real-World On-Label Treatment Persistence in Patients with Psoriatic Arthritis Receiving Guselkumab Versus Subcutaneous Tumor Necrosis Factor Inhibitors.

Walsh J, Lin I, Zhao R, Shiff N, Morrison L, Emond B Drugs Real World Outcomes. 2024; 11(3):487-499.

PMID: 39083163 PMC: 11365907. DOI: 10.1007/s40801-024-00428-z.

A systematic review of sex and gender differences in treatment outcome of inflammatory skin diseases: Is it time for new guidelines?.

Preis S, Ziehfreund S, Biedermann T, Horster S, Zink A J Eur Acad Dermatol Venereol. 2024; 39(3):512-528.

PMID: 39078087 PMC: 11851263. DOI: 10.1111/jdv.20256.

Gender Differences in Perceptions of Psoriatic Arthritis Disease Impact, Management, and Physician Interactions: Results from a Global Patient Survey.

Eder L, Richette P, Coates L, Azevedo V, Cappelleri J, Johnson E Rheumatol Ther. 2024; 11(5):1115-1134.

PMID: 38958912 PMC: 11422324. DOI: 10.1007/s40744-024-00678-x.

References

Yeung H, Wan J, Van Voorhees A, Callis Duffin K, Krueger G, Kalb R . Patient-reported reasons for the discontinuation of commonly used treatments for moderate to severe psoriasis. J Am Acad Dermatol. 2012; 68(1):64-72. PMC: 3488143. DOI: 10.1016/j.jaad.2012.06.035. View

Iskandar I, Warren R, Lunt M, Mason K, Evans I, Mcelhone K . Differential Drug Survival of Second-Line Biologic Therapies in Patients with Psoriasis: Observational Cohort Study from the British Association of Dermatologists Biologic Interventions Register (BADBIR). J Invest Dermatol. 2017; 138(4):775-784. PMC: 5869053. DOI: 10.1016/j.jid.2017.09.044. View

Glintborg B, Ostergaard M, Krogh N, Andersen M, Tarp U, Loft A . Clinical response, drug survival, and predictors thereof among 548 patients with psoriatic arthritis who switched tumor necrosis factor α inhibitor therapy: results from the Danish Nationwide DANBIO Registry. Arthritis Rheum. 2013; 65(5):1213-23. DOI: 10.1002/art.37876. View

Zweegers J, van den Reek J, van de Kerkhof P, Otero M, Kuijpers A, Koetsier M . Body mass index predicts discontinuation due to ineffectiveness and female sex predicts discontinuation due to side-effects in patients with psoriasis treated with adalimumab, etanercept or ustekinumab in daily practice: a prospective, comparative,.... Br J Dermatol. 2016; 175(2):340-7. DOI: 10.1111/bjd.14552. View

da Silva M, Dos Santos J, Almeida A, Itria A, Kakehasi A, Teodoro J . Medication persistence for psoriatic arthritis in a Brazilian real-world setting. Future Sci OA. 2019; 5(2):FSO369. PMC: 6391629. DOI: 10.4155/fsoa-2018-0101. View

Cozzani E, Wei Y, Burlando M, Signori A, Parodi A . Serial biologic therapies in psoriasis patients: A 12-year, single-center, retrospective observational study. J Am Acad Dermatol. 2019; 82(1):37-44. DOI: 10.1016/j.jaad.2019.05.064. View

Lunder T, Zorko M, Kolar N, Suhodolcan A, Marovt M, Leskovec N . Drug survival of biological therapy is showing class effect: updated results from Slovenian National Registry of psoriasis. Int J Dermatol. 2019; 58(6):631-641. DOI: 10.1111/ijd.14429. View

DAngelo S, Cantini F, Ramonda R, Cantarini L, Carletto A, Chimenti M . Effectiveness of Adalimumab for the Treatment of Psoriatic Arthritis: An Italian Real-Life Retrospective Study. Front Pharmacol. 2020; 10:1497. PMC: 6923751. DOI: 10.3389/fphar.2019.01497. View

Walsh J, Adejoro O, Chastek B, Palmer J, Hur P . Treatment Patterns Among Patients with Psoriatic Arthritis Treated with a Biologic in the United States: Descriptive Analyses from an Administrative Claims Database. J Manag Care Spec Pharm. 2018; 24(7):623-631. PMC: 10397599. DOI: 10.18553/jmcp.2018.24.7.623. View

10.

Stober C, Ye W, Guruparan T, Htut E, Clunie G, Jadon D . Prevalence and predictors of tumour necrosis factor inhibitor persistence in psoriatic arthritis. Rheumatology (Oxford). 2017; 57(1):158-163. DOI: 10.1093/rheumatology/kex387. View

11.

Murage M, Tongbram V, Feldman S, Malatestinic W, Larmore C, Muram T . Medication adherence and persistence in patients with rheumatoid arthritis, psoriasis, and psoriatic arthritis: a systematic literature review. Patient Prefer Adherence. 2018; 12:1483-1503. PMC: 6110273. DOI: 10.2147/PPA.S167508. View

12.

Egeberg A, Ottosen M, Gniadecki R, Broesby-Olsen S, Dam T, Bryld L . Safety, efficacy and drug survival of biologics and biosimilars for moderate-to-severe plaque psoriasis. Br J Dermatol. 2017; 178(2):509-519. DOI: 10.1111/bjd.16102. View

13.

Oelke K, Chambenoit O, Majjhoo A, Gray S, Higgins K, Hur P . Persistence and adherence of biologics in US patients with psoriatic arthritis: analyses from a claims database. J Comp Eff Res. 2019; 8(8):607-621. DOI: 10.2217/cer-2019-0023. View

14.

Jacobi A, Rustenbach S, Augustin M . Comorbidity as a predictor for drug survival of biologic therapy in patients with psoriasis. Int J Dermatol. 2015; 55(3):296-302. DOI: 10.1111/ijd.12879. View

15.

Chastek B, White J, Van Voorhis D, Tang D, Stolshek B . A Retrospective Cohort Study Comparing Utilization and Costs of Biologic Therapies and JAK Inhibitor Therapy Across Four Common Inflammatory Indications in Adult US Managed Care Patients. Adv Ther. 2016; 33(4):626-42. PMC: 4846706. DOI: 10.1007/s12325-016-0312-y. View

16.

Fagerli K, Kearsley-Fleet L, Watson K, Packham J, Contributors Group B, Symmons D . Long-term persistence of TNF-inhibitor treatment in patients with psoriatic arthritis. Data from the British Society for Rheumatology Biologics Register. RMD Open. 2018; 4(1):e000596. PMC: 5822639. DOI: 10.1136/rmdopen-2017-000596. View

17.

Sauer B, Teng C, He T, Leng J, Lu C, Walsh J . Treatment patterns and annual biologic costs in US veterans with rheumatic conditions or psoriasis. J Med Econ. 2015; 19(1):34-43. DOI: 10.3111/13696998.2015.1086774. View

18.

Grantham H, Reynolds N . The devil is in the data: differences in drug persistence between SNIIRAM, the French national health insurance database, and psoriasis biologics intervention registers. Br J Dermatol. 2019; 180(1):8-10. DOI: 10.1111/bjd.17275. View

19.

Palmer J, Li Y, Herrera V, Liao M, Tran M, Ozturk Z . Treatment patterns and costs for anti-TNFα biologic therapy in patients with psoriatic arthritis. BMC Musculoskelet Disord. 2016; 17:261. PMC: 4908678. DOI: 10.1186/s12891-016-1102-z. View

20.

Kristensen L, Gulfe A, Saxne T, Geborek P . Efficacy and tolerability of anti-tumour necrosis factor therapy in psoriatic arthritis patients: results from the South Swedish Arthritis Treatment Group register. Ann Rheum Dis. 2007; 67(3):364-9. DOI: 10.1136/ard.2007.073544. View