According to study data published in the Journal of the American Academy of Dermatology, patients with psoriasis administered ixekizumab demonstrated higher persistence and lower discontinuation rates than patients administered secukinumab.
Investigators abstracted administrative claims data from 3 IBM Watson Health MarketScan Databases. Adult (≥18 years) patients with psoriasis and ≥1 claim for ixekizumab or secukinumab between March 1, 2016, and May 31, 2018, were eligible for inclusion. Treatment persistence, discontinuation, adherence, and switching were assessed during the follow-up period. Index treatment was considered persistent if gaps between prescription fills were <60 days. Discontinuation was defined as a treatment gap ≥90 days. Medication possession ratio, calculated as the sum of pill supply divided by total follow-up, was used as a proxy for adherence. Inverse probability of treatment weighting was used to address imbalances across database cohorts. Cox proportional hazard models were used to assess risk for nonpersistence, discontinuation, adherence, and switching. Covariates included demographic characteristics, comorbid conditions, prior biologics use, and total all-cause healthcare costs.
Data were analyzed for 645 patients administered ixekizumab and 1152 patients administered secukinumab. Demographic and clinical characteristics were similar in both cohorts. Mean (standard deviation) age across groups was 49 to50 (12.0) years, and approximately half of all patients were men. Length of follow-up was 13.7 and 16.3 months in the ixekizumab and secukinumab groups, respectively. Patients administered ixekizumab demonstrated a higher persistence rate (54.8% vs 45.1%) and a lower discontinuation rate (37.8% vs 47.5%) compared with the secukinumab group (both P <.001). In the multivariable adjusted model, patients administered ixekizumab had lower risk for nonpersistence (hazard ratio [HR], 0.82; 95% CI, 0.71-0.95) and discontinuation (HR, 0.82; 95% CI, 0.70-0.96) than patients administered secukinumab. In the same model, the ixekizumab group was more likely to have high treatment adherence, defined as a medication possession ratio ≥80% (HR, 1.31; 95% CI 1.07-1.60). However, the risk for switching treatments was not significantly lower in the ixekizumab group compared with the secukinumab group (HR, 0.88; 95% CI, 0.70-1.11).
These data demonstrate real-world trends in biologics use in adult patients with psoriasis, the researchers observed. Overall, patients administered ixekizumab tended to remain on the drug longer than patients administered secukinumab. As a study limitation, investigators noted that data on psoriasis severity and clinical outcomes were not available in the claims databases. Even so, these results may aid clinicians in the “decision-making process when considering an [interleukin]-17A blocker for psoriasis,” investigators wrote.
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Blauvelt A, Shi N, Burge R, et al. Comparison of real-world treatment patterns among psoriasis patients prescribed ixekizumab or secukinumab [published online November 8, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2019.11.015