Real-world switching patterns and associated characteristics in patients with psoriasis treated with biologics in the United States

Abstract

Background

Switching therapies is common for patients with psoriasis.

Objective

To quantify real-world switching rates and characteristics among patients initiating biologics over 24 months.

Methods

Patients aged ≥18 years with ≥2 confirmed psoriasis diagnoses who initiated a new biologic were identified from a US-payer claims database (Merative® MarketScan®) Switching rates were reported over 24 months using Kaplan–Meier survival analysis, and multivariable Cox regression analyses were performed to identify associated patient characteristics.

Results

A total of 7997 patients were included, with overall treatment switch rates at 14.4% at 12 months and 26.0% at 24 months. IL-23 inhibitors were associated with the lowest risk of switching compared with TNF, IL-17, and IL-12/23 inhibitors over 24 months (p < 0.0001). Switch rates varied between specific biologics, with the lowest switch rates observed for patients treated with risankizumab at 8.5% followed by guselkumab at 15.7% over 24 months. Prior targeted immune modulator use, age, and female gender were predictors of switching (adjusted hazard ratio; 1.23, 1.31, and 1.40, respectively; p ≤ 0.0005).

Limitations

Claims data may be subject to data errors and reasons for switching cannot be determined.

Conclusion

Switching was common in psoriasis patients using biologics over 24 months, with the lowest risk of switching observed with IL-23 inhibitors.

Keywords:

• Biologics
• psoriasis
• real-world evidence
• treatment patterns

Acknowledgments

Medical writing assistance was provided by Sarah Hodgkinson PhD, of Fishawack Facilitate Ltd, part of Fishawack Health, and was funded by AbbVie Inc., North Chicago, IL.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure statement

AW Armstrong has served as a research investigator and/or scientific advisor to AbbVie, Almirall, Arcutis, ASLAN, Beiersdorf, BI, BMS, Dermavant, Dermira, EPI, Incyte, Leo, UCB, Janssen, Lilly, Nimbus, Novartis, Ortho Dermatologics, Sun, Sanofi, Regeneron, Pfizer, and Modmed. M Patel, C Li, V Garg, and MR Mandava are employees of AbbVie and may own AbbVie stock. JJ Wu is or has been an investigator, consultant, and/or speaker 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, Pfizer, Regeneron, Samsung Bioepis, Sanofi Genzyme, Solius, Sun Pharmaceutical, UCB, and Zerigo Health.

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 permission from Merative® MarketScan® Research.

Additional information

Funding

This work was supported by AbbVie Inc., North Chicago, IL. AbbVie sponsored the study; contributed to the design; participated in the collection, analysis, and interpretation of data; and in writing, reviewing, and approval of the final version. All authors had access to the data results, and participated in the development, review, and approval of this manuscript. No honoraria or payments were made for authorship. Medical writing assistance was provided by Sarah Hodgkinson PhD, of Fishawack Facilitate Ltd, part of Fishawack Health, and was funded by AbbVie.