Pinter Andreas, Soliman Ahmed M, Manz Karina C, Weber Valeria, Ludwig Paul, Mocek Anja, Höer Ariane, Lebwohl Mark G
Clinical Research Division, Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt/Main, University of Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Abbvie Inc, North Chicago, USA.
Dermatol Ther (Heidelb). 2024 Jun;14(6):1575-1585. doi: 10.1007/s13555-024-01172-6. Epub 2024 May 24.
Plaque psoriasis is a common, often debilitating, chronic autoimmune inflammatory skin disease. Moderate-to-severe forms of psoriasis can be treated with biologics such as anti-interleukin and anti-tumor necrosis factor antibodies. We aimed to investigate treatment discontinuation among patients with psoriasis who initiated biologic treatment.
We conducted a retrospective, non-interventional cohort study based on anonymized claims data from the German statutory health insurance which covered the years from 2016 to 2021. We included adult patients with psoriasis who initiated biologic treatment in drug-specific cohorts. Over a 365-day follow-up period, we assessed the frequencies and the time until treatment discontinuation for different biologics. Differences in discontinuation rates were compared using a multivariate Cox proportional hazards model.
A total of 2565 patients with psoriasis who initiated treatment with secukinumab (n = 612), adalimumab (n = 454), guselkumab (n = 354), ixekizumab (n = 259), ustekinumab (n = 241), tildrakizumab (n = 205), brodalumab (n = 166), risankizumab (n = 145), etanercept (n = 91), certolizumab (n = 29), and infliximab (n = 9) were included. A total of 1290 patients (50.29%) discontinued treatment during the follow-up period, ranging from 30.34% (risankizumab) to 69.23% (etanercept). Median time until discontinuation of treatment ranged from 102 days (etanercept) to 208 days (risankizumab). Once the biologic treatment was discontinued, 45.05% of patients restarted the treatment with the same agent, 23.10% of patients switched to another biologic, and 31.86% received no further biologic agent. Compared to patients treated with risankizumab, the treatment discontinuation rate was significantly higher (p < 0.05) in patients treated with the other biologics except ustekinumab (p = 0.12).
Further research should explore reasons leading to treatment discontinuation in order to support treatment choices for patients with moderate-to-severe psoriasis.
斑块状银屑病是一种常见的、往往使人衰弱的慢性自身免疫性炎症性皮肤病。中重度银屑病可用抗白细胞介素和抗肿瘤坏死因子抗体等生物制剂治疗。我们旨在调查开始生物制剂治疗的银屑病患者的治疗中断情况。
我们基于德国法定医疗保险2016年至2021年的匿名理赔数据进行了一项回顾性、非干预性队列研究。我们纳入了在特定药物队列中开始生物制剂治疗的成年银屑病患者。在365天的随访期内，我们评估了不同生物制剂治疗中断的频率和时间。使用多变量Cox比例风险模型比较中断率的差异。
共有2565例银屑病患者开始使用司库奇尤单抗（n = 612）、阿达木单抗（n = 454）、古塞库单抗（n = 354）、依奇珠单抗（n = 259）、乌司奴单抗（n = 241）、替拉珠单抗（n = 205）、布罗达单抗（n = 166）、瑞莎珠单抗（n = 145）、依那西普（n = 91）、赛妥珠单抗（n = 29）和英夫利昔单抗（n = 9）进行治疗。共有1290例患者（50.29%）在随访期间中断治疗，中断率从30.34%（瑞莎珠单抗）到69.23%（依那西普）不等。治疗中断的中位时间从102天（依那西普）到208天（瑞莎珠单抗）不等。生物制剂治疗中断后，45.05%的患者重新使用同一药物治疗，23.10%的患者换用另一种生物制剂，31.86%的患者未再接受生物制剂治疗。与使用瑞莎珠单抗治疗的患者相比，除乌司奴单抗（p = 0.12）外，使用其他生物制剂治疗的患者治疗中断率显著更高（p < 0.05）。
应进一步研究导致治疗中断的原因，以支持中重度银屑病患者的治疗选择。
