Biologic drug survival rates in the era of anti-interleukin-17 antibodies: a time-period-adjusted registry analysis

T Graier, W Salmhofer, C Jonak, W Weger, C Kölli, B Gruber, P G Sator, K Prillinger, A Mlynek, M Schütz-Bergmayr, L Richter, G Ratzinger, C Painsi, S Selhofer, N Häring, K Wippel-Slupetzky, H Skvara, H Trattner, A Tanew, M InzingerR Tatarski, C Bangert, C Ellersdorfer, R Lichem, A Gruber-Wackernagel, A Hofer, F Legat, E Schmiedberger, R Strohal, B Lange-Asschenfeldt, M Schmuth, I Vujic, W Hoetzenecker, F Trautinger, W Saxinger, R Müllegger, F Quehenberger, P Wolf

Research output: Journal article (peer-reviewed)Journal article

25 Citations (Scopus)

Abstract

BACKGROUND: Drug survival rates reflect efficacy and safety and may be influenced by the availability of alternative treatment options. Little is known about time-dependent drug survival in psoriasis and the effect of increasing numbers of biologic treatment options.

OBJECTIVES: To determine whether drug survival is influenced by the availability of treatment options and by factors such as gender, psoriatic arthritis or previous biologic treatment.

METHODS: This observational, retrospective, multicentre cohort study analysed data from patients registered in the Austrian Psoriasis Registry (PsoRA) who were treated with biologics between 1 January 2015 and 30 November 2019.

RESULTS: A total of 1572 patients who received 1848 treatment cycles were included in this analysis. The highest long-term Psoriasis Area and Severity Index improvement was observed after treatment with ixekizumab, followed by ustekinumab and secukinumab, adalimumab and etanercept. Overall, ustekinumab surpassed all other biologics in drug survival up to 48 months. However, when adjusted for biologic naïvety, its superiority vanished and drug survival rates were similar for ixekizumab (91·6%), secukinumab (90·2%) and ustekinumab (92·8%), all of them superior to adalimumab (76·5%) and etanercept (71·9%) at 12 months and beyond. Besides biologic non-naïvety (2·10, P < 0·001), the introduction of a new drug such as secukinumab or ixekizumab (relative hazard ratio 1·6, P = 0·001) and female gender (1·50, P = 0·019) increased the risk of treatment discontinuation overall, whereas psoriatic arthritis did not (1·12, P = 0·21).

CONCLUSIONS: The time-dependent availability of drugs should be considered when analysing and comparing drug survival. Previous biologic exposure significantly influences drug survival. Women are more likely to stop treatment.

Original languageEnglish
Pages (from-to)1094-1105
Number of pages12
JournalBritish Journal of Dermatology
Volume184
Issue number6
DOIs
Publication statusPublished - Jun 2021

Keywords

  • Adalimumab
  • Austria
  • Biological Products
  • Cohort Studies
  • Etanercept
  • Female
  • Humans
  • Psoriasis/drug therapy
  • Registries
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome
  • Ustekinumab

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