https://orcid.org/0000-0002-2407-2995
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Abstract
Purpose
Psoriasis and psoriatic arthritis (PsA) are associated with an increased infection risk. In this cohort study of patients with treated psoriasis or PsA, we used MarketScan (2014–2018) to estimate rates of herpes zoster, hepatitis C (HepC) and tuberculosis (TB) with apremilast compared to other systemic treatments.
Materials and Methods
Patients were exposed from first apremilast [APR], DMARD, TNF-inhibitor [TNF], IL-inhibitor [IL], or corticosteroids [CS] prescription after March 21, 2014. Study exposures were APR, DMARDs only, TNF-only, IL-only, CS-only, DMARDs+CS, TNF+DMARDs and/or CS, IL+DMARDs and/or CS. Cases had treated herpes zoster, HepC, or TB event. We calculated incidence rates (IRs) [95% confidence intervals] per 1000 patient-years.
Results
The study population included 131,604 patients. For herpes zoster (N=2271), IRs were highest for users of DMARDs+CS (12.5 [9.8–15.7]), CS-only (12.5 [10.4–14.1]), and TNF+DMARDs and/or CS (11.9 [10.6–13.4]), compared with DMARDs only (9.9 [8.7–11.2]). IRs were lowest for users of IL-only (6.7 [5.8–7.8]) and APR (7.0 [5.8–8.4]). IRs of HepC (N=150) and TB (N=81) were low and between-treatment differences were not significant.
Conclusion
Rates of herpes zoster varied by treatment: highest among those who received polytherapy, lowest in users of apremilast only. IRs for HepC and TB were low for all exposures.
Acknowledgments
This study was supported by Celgene Corporation (Summit, NJ 07901). The abstract entitled “Rates of Herpes Zoster, hepatitis C, and tuberculosis among patients with psoriasis treated with apremilast, biologics, DMARDs, and corticosteroids: a cohort study in the US MarketScan Database” was submitted for presentation at American Academy of Dermatology 2020 Annual Meeting. While related to the paper that we have submitted for publication, this abstract presents preliminary results on a subgroup of patients with psoriasis.
Disclosure
Ms Katrina Wilcox Hagberg reports grants from Celgene Corp, during the conduct of the study. Ms Rebecca Persson reports grants from Celgene Corporation, during the conduct of the study; grants from Celgene Corporation and AbbVie Inc., outside the submitted work. Dr Catherine Vasilakis-Scaramozza reports grants from Celgene Corporation, during the conduct of the study. Dr Steve Niemcryk is an employee of Celgene Corp, and owns stock in Celgene Corp. Dr Michael Peng, Dr Maria Paris, and Dr Anders Lindholm are employees of Celgene Corp. Dr Susan Jick reports grants from Celgene Corp, during the conduct of the study. The authors report no other conflicts of interest in this work.