Real-world dose escalation of biologics for moderate-to-severe psoriasis in the United States

Abstract

Aim

To compare real-world dose escalation of risankizumab with other US Food and Drug Administration (FDA)-approved biologic treatments for management of moderate-to-severe psoriasis (PsO) in the United States.

Methods

The Merative® MarketScan® Research Database was used to identify adults with ≥2 medical claims for PsO, ≥3 claims of the index biologic medication in the maintenance period, and ≥6 months continuous enrollment pre-induction and ≥6 months after initiation of the maintenance period. Dose escalation was defined as ≥2 dosing intervals where the average daily dose was ≥30% higher than the expected daily dose (per FDA-approved dosing). Comparisons between risankizumab and other cohorts were made using chi-square tests and logistic regression models.

Results

At the 30% threshold, the percentage of patients with dose escalation in the full maintenance period was significantly lower with risankizumab (2.0%) compared with other drug classes (tumor necrosis factor, interleukin (IL)-12/23, IL-17, or other IL-23 inhibitors: 17.6%, 10.0%, 18.3%, or 7.1%, respectively; p < 0.0001 for each) and individual biologics (adalimumab, ustekinumab, secukinumab, ixekizumab, and guselkumab; 17.9%, 10.0%, 15.7%, 18.0%, and 7.2%, respectively; p < 0.0001).

Conclusion

A significantly lower proportion of risankizumab-treated patients with PsO had dose escalations compared with patients treated with other biologics.

Keywords:

• Psoriasis
• real-world data
• dose escalation

Acknowledgments

Medical writing services provided by Natalie Mitchell, of Fishawack Facilitate Ltd, part of Fishawack Health, and funded by AbbVie.

Author contributions

AbbVie participated in the study design, research, data collection, analysis and interpretation of data, writing, reviewing, and approving the publication. All authors had access to the data results and participated in the development, review, and approval of this manuscript.

Disclosure statement

Jashin Wu is or has been an investigator for AbbVie, Amgen, Eli Lilly, Janssen, Novartis, and Pfizer; a consultant for AbbVie, Almirall, Amgen, Arcutis, Aristea Therapeutics, Bausch Health, Boehringer Ingelheim, Bristol Myers Squibb, Dermavant, DermTech, Dr. Reddy’s Laboratories, Eli Lilly, EPI Health, Galderma, Janssen, LEO Pharma, Mindera, Novartis, Regeneron, Samsung Bioepis, Sanofi Genzyme, Solius, Sun Pharmaceutical, UCB, and Zerigo Health; and a speaker for AbbVie, Amgen, Bausch Health, Novartis, Regeneron, Sanofi Genzyme, Sun Pharmaceutical, and UCB.

Feng Zeng was a paid employee of Tigermed-BDM, which is a paid consultant to AbbVie, when she worked on this project. She is currently employed by Shionogi Inc, Florham Park, NJ, USA.

Ahong Huang, Xing Pan, and Yiwen Cao are paid employees of Tigermed-BDM, which is a paid consultant to AbbVie.

Manish Patel, Naijun Chen, Huzefa Photowala, and Vishvas Garg are full-time salaried employees of AbbVie and may own stock/options.

Jeff Crowley has received research/grant support from AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Janssen, Lilly, MC2 Therapeutics, Merck, Novartis, Pfizer, Regeneron, Sandoz, Sanofi, Sun Pharma, UCB, and Verrica. He has served as a consultant for AbbVie, Amgen, BMS, Celgene, Dermira, Lilly, Novartis, Sun Pharma, and UCB; and has worked on speaker bureaus for AbbVie, BMI, Boehringer Ingelheim, Janssen, Lilly, Novartis, Regeneron, Sanofi, and UCB.

Data availability statement

The data that support the findings of this study are available from Merative® MarketScan® Research. Restrictions apply to the availability of these data, which were used under license for this study. Data are available from the corresponding author upon request with the permission from Merative® MarketScan® Research.

Additional information

Funding

This work was supported by AbbVie, Inc. No honoraria or payments were made for authorship.