Blauvelt Andrew, Burge Russel, Gallo Gaia, Charbonneau Bridget, Malatestinic William, Zhu Baojin, Wan Fangyu, Lockshin Benjamin
Oregon Medical Research Center, 9495 SW Locust St., Suite G, Portland, OR, 97223, USA.
Eli Lilly and Company, Indianapolis, IN, USA.
Dermatol Ther (Heidelb). 2022 Mar;12(3):701-714. doi: 10.1007/s13555-022-00686-1. Epub 2022 Feb 26.
Persistence and adherence to psoriasis treatments reflect overall drug effectiveness, tolerability, and convenience. Limited data are available on the treatment patterns of ixekizumab, an interleukin (IL)-17A antagonist, vs. guselkumab, an IL-23 inhibitor. Our objective was to evaluate real-life psoriasis drug treatment patterns with ixekizumab vs. guselkumab.
This retrospective observational study used United States insurance claims data from IBM Watson MarketScan Databases to analyze treatment patterns (including adherence, persistence, time on monotherapy, switching, and use of concomitant medications) for patients with 1 year, ≥ 6 months, and up to 30 months of follow-up. Outcomes were compared between ixekizumab and guselkumab on the balanced sample after applying inverse probability of treatment weighting (IPTW).
Data for 1414 eligible patients (ixekizumab, N = 674 and guselkumab, N = 740) were assessed. Over the 1-year follow-up, adherence was greater for ixekizumab vs. guselkumab when evaluated by proportion of days covered ≥ 80% [odds ratio (OR) 1.77 (95% confidence interval, 1.41, 2.21), p < 0.001] and by medication possession ratio ≥ 80% [OR = 1.92 (1.54, 2.38), p < 0.001]. Persistence was longer for ixekizumab vs. guselkumab with a 60-day allowable gap [non-persistence hazard ratio (HR) (95% confidence interval): 0.80 (0.69, 0.93), p = 0.005], but there were no differences with a 90-day allowable gap [HR = 0.98 (0.83, 1.17), p = 0.850]. Results assessed in patients with ≥ 6 months follow-up confirmed these findings. This retrospective analysis of a United States claims database used prescription refill data to estimate persistence/adherence.
Based on real-world evidence using claims data, patients with psoriasis treated with ixekizumab had a greater adherence to and an equal or greater persistence with therapy vs. patients treated with guselkumab.
银屑病治疗的持续性和依从性反映了药物的总体有效性、耐受性和便利性。关于白细胞介素（IL）-17A拮抗剂司库奇尤单抗与IL-23抑制剂古塞奇尤单抗的治疗模式，现有数据有限。我们的目的是评估司库奇尤单抗与古塞奇尤单抗在银屑病实际药物治疗中的模式。
这项回顾性观察研究使用了来自IBM Watson MarketScan数据库的美国保险理赔数据，以分析随访1年、≥6个月及最长30个月的患者的治疗模式（包括依从性、持续性、单药治疗时间、换药情况以及联合用药的使用）。在应用治疗权重的逆概率（IPTW）后，对司库奇尤单抗和古塞奇尤单抗在平衡样本中的结果进行比较。
评估了1414例符合条件的患者的数据（司库奇尤单抗组，N = 674；古塞奇尤单抗组，N = 740）。在1年的随访中，当以覆盖天数比例≥80%评估时，司库奇尤单抗的依从性高于古塞奇尤单抗[优势比（OR）1.77（95%置信区间，1.41，2.21），p < 0.001]；以药物持有率≥80%评估时，情况相同[OR = 1.92（1.54，2.38），p < 0.001]。司库奇尤单抗的持续性长于古塞奇尤单抗，允许有60天的间隔[非持续性风险比（HR）（95%置信区间）：0.80（0.69，0.93），p = 0.005]，但在允许有90天间隔时无差异[HR = 0.98（0.83，1.17），p = 0.850]。对随访≥6个月的患者进行的结果评估证实了这些发现。这项对美国理赔数据库的回顾性分析使用了处方再填充数据来估计持续性/依从性。
基于使用理赔数据的真实世界证据，与接受古塞奇尤单抗治疗的患者相比，接受司库奇尤单抗治疗的银屑病患者对治疗的依从性更高，且治疗的持续性相同或更高。
