Real-world registry-based study on apremilast use in psoriasis and psoriatic arthritis in Finland

Figures & data

Table 1. Patient characteristics and comparison of the sub-cohorts.

	All patients (N = 43 558)		Apremilast users (n = 471)		Biologic therapy users (n = 4214)		p (apremilast vs all)	p (apremilast vs biologics)
PsA diagnosis	12 386	28.4%	318	67.5%	2812	66.7%
Demographics
Males	22 266	51.1%	249	52.9%	2426	57.6%	0.479	0.040*
Age† (years), mean ± sd	55.8	(17.9)	55.9	(13.1)	52.4	(14.1)	0.809	< 0.001*
Age < 18	1234	2.8%	0	0.0%	57	1.4%
Age 18–44	9988	22.9%	95	20.1%	1120	26.6%
Age 45–54	6677	15.3%	106	22.5%	991	23.5%
Age 55–64	9729	22.3%	142	30.1%	1179	28.0%
Age 65–90	15 597	35.8%	128	27.3%	867	20.6%
Age > 90	333	0.8%	0	0.0%	0	0.0%
Comorbidities
Charlson comorbidity score, mean ± sd	0.63	(0.94)	0.71	(0.92)	0.54	(0.85)	0.056	< 0.001*
Acute coronary syndrome	1118	2.6%	13	2.8%	67	1.6%	0.798	0.064
Cardiac disease	16 419	37.7%	192	40.8%	1322	31.4%	0.154	< 0.001*
Cerebrovascular disease	1920	4.4%	18	3.8%	98	2.3%	0.531	0.049*
Thromboembolism	500	1.1%	8	1.7%	38	0.9%	0.268	0.097
Renal disease	1108	2.5%	18	3.8%	91	2.2%	0.082	0.024*
Diabetes	7264	16.7%	81	17.2%	581	13.8%	0.779	0.046*
Infectious disease	22 280	51.2%	253	53.6%	2009	47.7%	0.289	0.015*
Asthma/COPD	5163	11.9%	59	12.5%	345	8.2%	0.666	< 0.001*
Cancer	4062	9.3%	43	9.1%	196	4.7%	0.873	< 0.001*

PsA, psoriatic arthritis; COPD, chronic obstructive pulmonary disease.

†Age at 31 December 2018.

*Significant difference (p < 0.05).

Figure 1. Treatment lines before initiation and after discontinuation of apremilast among patients with psoriatic arthritis (PsA) and patients with psoriasis (PsO). (Other medication: azathioprine, hydroxychloroquine, or sodium aurothiomalate). TNF, tumour necrosis factor.

Figure 2. Kaplan–Meier analysis of apremilast persistence. (A) Patients with psoriatic arthritis (PsA) and patients with psoriasis (PsO); (B) treatment line before apremilast initiation (the most recent treatment before apremilast initiation); (C) age group. y-axis: probability of continuing apremilast treatment; x-axis: time from apremilast initiation to discontinuation (months).

Table 2. Multivariate Cox regression analysis of apremilast discontinuation.

	Multivariate
Variable	HR	95% CI	p
Gender (female)	1.0		Reference category
Gender (male)	0.94	0.73–1.21	0.612
Age	0.99	0.98–1.00	0.042*
Comorbidity score	1.16	1.00–1.35	0.046*
Type PsA	1.0		Reference category
Type PsO	0.71	0.53–0.95	0.020*
Prior therapy: conventional	1.0		Reference category
Prior therapy: biological	2.15	1.42–3.25	< 0.001*
Prior therapy: none/topical	0.77	0.50–1.17	0.219
Prior therapy: other	2.09	1.15–3.78	0.015*

PsA, psoriatic arthritis; PsO, psoriasis; HR, hazard ratio; CI, confidence interval.

*Significant difference (p < 0.05).