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Drug Persistence of Biologic Treatments in Psoriasis: A Swedish National Population Study
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology. Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0002-3858-8474
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology. Parexel International, Stockholm, Sweden.
Parexel International, Stockholm, Sweden.
LEO Pharma A/S, Ballerup, Denmark.
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2021 (English)In: Dermatology and Therapy, ISSN 2193-8210, Vol. 11, no 6, p. 2107-2121Article in journal (Refereed) Published
Abstract [en]

Introduction: Biologic treatments for psoriasis are commonly switched. Treatment persistence represents an important parameter related to long-term therapeutic performance. The objective of the study was to analyse the real-world persistence with biologics over time in the treatment of psoriasis.

Methods: A retrospective observational study of adults with psoriasis was conducted based on Swedish national registry data from 2010 to 2018. Patients included were treated with a biologic between 2010 and 2018. Treatment episodes were identified from the drug’s date of dispensation recorded in the Prescribed Drug Register to the end of supply of the drug. Median persistence was estimated by Kaplan–Meier survival curves for patients who received adalimumab, etanercept, secukinumab, ustekinumab and ixekizumab. Descriptive analysis of change in persistence over time for 3-year running cohorts was also carried out.

Results: A total of 2292 patients were analysed. Patients who received ustekinumab had the longest median persistence [49.3 months, 95% confidence interval (CI) 38.0–59.1] and etanercept the shortest (16.3 months, 95% CI 14.5–19.0). Median persistence was longer in biologic-naive than biologic-exposed patients. Persistence for ustekinumab decreased by almost 50% over the study period, from a median of 62.3 (95% CI 45.6–∞) months in 2010–2011 to 32.7 (21.2–49.3) months in 2014–2016.

Conclusions: Persistence with biologics was, on average, relatively low, given the chronic nature of psoriasis. Changes in persistence over time seemed to be attributable to changes in the therapeutic landscape, providing patients with more options to switch biologic treatments if their current management was considered suboptimal.

Place, publisher, year, edition, pages
Adis , 2021. Vol. 11, no 6, p. 2107-2121
Keywords [en]
Biologics, Persistence, Psoriasis, Real-world data
National Category
Dermatology and Venereal Diseases
Research subject
Dermatology and Venerology
Identifiers
URN: urn:nbn:se:umu:diva-188877DOI: 10.1007/s13555-021-00616-7ISI: 000708374500001PubMedID: 34661864Scopus ID: 2-s2.0-85117210238OAI: oai:DiVA.org:umu-188877DiVA, id: diva2:1607314
Available from: 2021-11-01 Created: 2021-11-01 Last updated: 2023-03-24Bibliographically approved

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Schmitt-Egenolf, MarcusFreilich, Jonatan

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