Real-World Discontinuation and Switching Patterns for Interleukin-Inhibitor Treatments in Patients with Moderate-to-Severe Psoriasis in Japan
Tada, Yayoi (Teikyo University School of Medicine)
Soliman, Ahmed M. (AbbVie Inc)
Ishii, Kanako (AbbVie GK)
Sakuma, Ryuta (AbbVie GK)
Puig Sanz, Lluís (Institut de Recerca Sant Pau)
Davis, Matthew (Medicus Economics, LLC)
Nunag, Dominic (Medicus Economics, LLC)
Pinter, Andreas (University Hospital of Frankfurt (Alemanya))
Imafuku, Shinichi (Fukuoka University Faculty of Medicine)
Universitat Autònoma de Barcelona

Date:	2024
Abstract:	Patients with moderate-to-severe psoriasis (PsO) treated with interleukin (IL)-inhibitors may require treatment modification to achieve disease control. This study evaluated discontinuation and switching of IL-inhibitors for PsO patients in Japan. Japan Medical Data Center claims (1/2005-5/2022) were used to identify patients with PsO diagnosis preceding a first IL-inhibitor claim (index date) with ≥ 6 months of eligibility prior. Treatment switch (claim for another biologic) and discontinuation (gap in care ≥ 150% of the days' supply of the preceding prescription) were assessed up to 24 months following initiation. Censored Kaplan-Meier time-to-event analyses calculated rates, and Cox proportional hazards models estimated hazard ratios (HRs) adjusting for baseline characteristics. The study included 1481 unique patients treated with brodalumab (BRO; n = 159), guselkumab (GUS; n = 360), ixekizumab (IXE; n = 279), risankizumab (RIS; n = 327), secukinumab (SEC; n = 366), tildrakizumab (n = 40; excluded due to limited data), and ustekinumab (UST; n = 262). At 12/24 months, 25. 9%/38. 6% of patients overall had discontinued their index IL-inhibitor and 13. 5%/21. 2% had switched to another biologic. Discontinuation at 12/24 months was lowest for RIS (11. 2%/17. 4%), followed by UST (17. 9%/32. 2%), IXE (27. 0%/37. 0%), GUS (29. 8%/43. 0%), SEC (35. 6%/53. 8%), and BRO (37. 2%/47. 2%). Switching showed a similar trend: RIS (5. 7%/10. 7%), UST (11. 2%/19. 9%), SEC (14. 7%/25. 7%), IXE (14. 8%/21. 5%), GUS (16. 9%/23. 2%), and BRO (19. 7%/26. 8%). HRs of discontinuation relative to RIS were 2. 07 for UST, 2. 59 for IXE, 2. 70 for GUS, 3. 65 for BRO, and 3. 69 for SEC (all P ≤ 0. 001). HRs of switching relative to RIS were 2. 05 for IXE, 2. 45 for GUS, 2. 67 for SEC, 2. 73 for UST, and 2. 77 for BRO (all P ≤ 0. 01). Treatment modification of IL-inhibitors for PsO was commonly observed and could indicate insufficient disease control and/or incremental economic burden. Discontinuation and switching rates were lowest for RIS regardless of time point and adjustment for patient characteristics. The online version contains supplementary material available at 10. 1007/s13555-023-01064-1.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Biologics ; Discontinuation ; Interleukin inhibitors ; Japan ; Persistence ; Psoriasis ; Switching ; Treatment patterns
Published in:	Dermatology and Therapy, Vol. 14 (november 2024) , p. 99-114, ISSN 2190-9172

DOI: 10.1007/s13555-023-01064-1
PMID: 38019410

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