OBJECTIVES: TNF inhibitors (TNFis) and IL inhibitors are effective treatments for PsA. Treatment non-persistence (drug survival, discontinuation) is a measure of effectiveness, tolerability and patient satisfaction or preferences in real-world clinical practice. Persistence on these treatments is not well understood in European PsA populations. The aim of this study was to compare time to non-persistence for either ustekinumab (IL-12/23 inhibitor) or secukinumab (IL-17 inhibitor) to a reference group of adalimumab (TNFi) treatment exposures in PsA patients and identify risk factors for non-persistence. METHODS: A total of 4649 exposures of adalimumab, ustekinumab, and secukinumab in 3918 PsA patients were identified in Swedish longitudinal population-based registry data. Kaplan-Meier curves were constructed to measure treatment-specific real-world risk of non-persistence and adjusted Cox proportional hazards models were estimated to identify risk factors associated with non-persistence. RESULTS: Ustekinumab was associated with a lower risk of non-persistence relative to adalimumab in biologic-naïve [hazard ratio (HR) 0.48 (95% CI 0.33, 0.69)] and biologic-experienced patients [HR 0.65 (95% CI 0.56, 0.76)], while secukinumab was associated with a lower risk in biologic-naïve patients [HR 0.65 (95% CI 0.49, 0.86)] but a higher risk of non-persistence in biologic-experienced patients [HR 1.20 (95% CI 1.03, 1.40)]. Biologic non-persistence was also associated with female sex, axial involvement, recent disease onset, biologic treatment experience and no psoriasis. CONCLUSION: Ustekinumab exhibits a favourable treatment persistency profile relative to adalimumab overall and across lines of treatment. The performance of secukinumab is dependent on biologic experience. Persistence and risk factors for non-persistence should be accounted for when determining an optimal treatment plan for patients.
OBJECTIVES: TNF inhibitors (TNFis) and IL inhibitors are effective treatments for PsA. Treatment non-persistence (drug survival, discontinuation) is a measure of effectiveness, tolerability and patient satisfaction or preferences in real-world clinical practice. Persistence on these treatments is not well understood in European PsA populations. The aim of this study was to compare time to non-persistence for either ustekinumab (IL-12/23 inhibitor) or secukinumab (IL-17 inhibitor) to a reference group of adalimumab (TNFi) treatment exposures in PsA patients and identify risk factors for non-persistence. METHODS: A total of 4649 exposures of adalimumab, ustekinumab, and secukinumab in 3918 PsA patients were identified in Swedish longitudinal population-based registry data. Kaplan-Meier curves were constructed to measure treatment-specific real-world risk of non-persistence and adjusted Cox proportional hazards models were estimated to identify risk factors associated with non-persistence. RESULTS: Ustekinumab was associated with a lower risk of non-persistence relative to adalimumab in biologic-naïve [hazard ratio (HR) 0.48 (95% CI 0.33, 0.69)] and biologic-experienced patients [HR 0.65 (95% CI 0.56, 0.76)], while secukinumab was associated with a lower risk in biologic-naïve patients [HR 0.65 (95% CI 0.49, 0.86)] but a higher risk of non-persistence in biologic-experienced patients [HR 1.20 (95% CI 1.03, 1.40)]. Biologic non-persistence was also associated with female sex, axial involvement, recent disease onset, biologic treatment experience and no psoriasis. CONCLUSION: Ustekinumab exhibits a favourable treatment persistency profile relative to adalimumab overall and across lines of treatment. The performance of secukinumab is dependent on biologic experience. Persistence and risk factors for non-persistence should be accounted for when determining an optimal treatment plan for patients.
Authors: Tomaz Lunder; Mateja S Zorko; Natasa K Kolar; Aleksandra B Suhodolcan; Maruska Marovt; Nada K Leskovec; Pij B Marko Journal: Int J Dermatol Date: 2019-04-11 Impact factor: 2.736
Authors: J Zweegers; J M P A van den Reek; P C M van de Kerkhof; M E Otero; A L A Kuijpers; M I A Koetsier; W P Arnold; M A M Berends; L Weppner-Parren; P M Ossenkoppele; M D Njoo; J M Mommers; P P M van Lümig; R J B Driessen; W Kievit; E M G J de Jong Journal: Br J Dermatol Date: 2016-06-25 Impact factor: 9.302
Authors: Howa Yeung; Joy Wan; Abby S Van Voorhees; Kristina Callis Duffin; Gerald G Krueger; Robert E Kalb; Jamie D Weisman; Brian R Sperber; Bruce A Brod; Stephen M Schleicher; Bruce F Bebo; Daniel B Shin; Andrea B Troxel; Joel M Gelfand Journal: J Am Acad Dermatol Date: 2012-07-28 Impact factor: 11.527
Authors: Ireny Y K Iskandar; Richard B Warren; Mark Lunt; Kayleigh J Mason; Ian Evans; Kathleen McElhone; Catherine H Smith; Nick J Reynolds; Darren M Ashcroft; Christopher E M Griffiths Journal: J Invest Dermatol Date: 2017-12-06 Impact factor: 7.590
Authors: Michael Ruberson Ribeiro da Silva; Jéssica Barreto Ribeiro Dos Santos; Alessandra Maciel Almeida; Alexander Itria; Adriana Maria Kakehasi; Juliana Alvares Teodoro; Francisco de Assis Acurcio Journal: Future Sci OA Date: 2019-01-18
Authors: Christopher T Ritchlin; Philip J Mease; Wolf-Henning Boehncke; John Tesser; Elena Schiopu; Soumya D Chakravarty; Alexa P Kollmeier; Xie L Xu; May Shawi; Yusang Jiang; Shihong Sheng; Yanli Wang; Stephen Xu; Joseph F Merola; Iain B McInnes; Atul Deodhar Journal: RMD Open Date: 2022-03
Authors: Laure Gossec; Stefan Siebert; Paul Bergmans; Kurt de Vlam; Elisa Gremese; Beatríz Joven-Ibáñez; Tatiana V Korotaeva; Frederic Lavie; Wim Noël; Michael T Nurmohamed; Petros P Sfikakis; Elke Theander; Josef S Smolen Journal: Ann Rheum Dis Date: 2022-02-24 Impact factor: 27.973