Pattern of drug use in patients with psoriatic arthritis in Italy: study in a real-world setting

ABSTRACT

Background: The aim of this study is to assess treatment patterns and pharmaco-utilization in patients with psoriatic arthritis (PsA) in Italy.

Methods: A retrospective analysis using administrative databases of six Local Health Units was performed. All adult patients with PsA diagnosis and ≥1 prescription for biologic/targeted-synthetic (b/ts) disease-modifying antirheumatic drugs (DMARDs) from January 2010 to March 2017 were included. The date of first b/tsDMARD prescription was defined index-date. Follow-up lasted 1-year post index-date. Patients without b/tsDMARDs prescription pre index-date were defined bionaïve.

Results: Of the 1,056 patients included, 33% received adalimumab, 30% etanercept, 10% golimumab, 9% secukinumab, 7% infliximab, 6% ustekinumab, 4% certolizumab, and 1% apremilast. During follow-up, persistence with b/tsDMARDs was observed in 79.8% of patients, 10.8% switched therapies, dose change occurred in 15.8% of patients, 47.4% received an add-on. Among bionaïve patients (n = 591), 67.0% were persistent with b/tsDMARDs, 10.1% switched therapy, 14.5% required a dose change and 45.8% an add-on. Discontinuation was observed in 10.6% of total PsA population and in 24.8% of bionaïve patients.

Conclusion: This analysis provided insights on drug utilization patterns for PsA in an Italian real-world setting. Our results show that treatment regimen changes occur in a high proportion of PsA patients.

KEYWORDS:

• Biological DMARDs
• drug utilization psoriatic arthritis
• real-world data
• treatment patterns

Declaration of interest

VP, DS and LDE report no conflicts of interest in this work. Clicon S.r.l. is an independent company. The agreement signed by Clicon S.r.l. and Eli Lilly does not create any entityship, joint venture or any similar relationship between parties. Neither CliCon S.r.l. nor any of their representatives are employees of Eli Lilly for any purpose. SL and EF are employees and minor stockholder at Eli Lilly Italy S.p.A. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewers Disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Author contribution statement

All authors met the criteria for authorship as per ICMJE guidelines and agree to be accountable for all aspects of the work.

Supplementary data

Supplemental data for this article can be accessed here.

Acknowledgments

A poster presentation with interim findings of this paper was presented at the 24^th World Congress of Dermatology in Milan.

The present manuscript was edited for proper English language, grammar, punctuation, spelling, and overall style by Mary A. from American Journal Experts (AJE).

Additional information

Funding

This study was sponsored by Eli Lilly. The views expressed here are those of the authors and not necessarily those of the sponsor.