Persistence of biologic treatments in psoriatic arthritis: a population-based study in Sweden.

Autor:	Geale K; Quantify Research, Stockholm, Sweden.; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden., Lindberg I; Quantify Research, Stockholm, Sweden., Paulsson EC; Quantify Research, Stockholm, Sweden., Wennerström ECM; Janssen-Cilag AB, Solna, Sweden.; Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark., Tjärnlund A; Janssen-Cilag AB, Solna, Sweden., Noel W; Janssen Pharmaceutica NV, Beerse, Belgium., Enkusson D; Janssen-Cilag AB, Solna, Sweden., Theander E; Janssen-Cilag AB, Solna, Sweden.
Jazyk:	angličtina
Zdroj:	Rheumatology advances in practice [Rheumatol Adv Pract] 2020 Dec 19; Vol. 4 (2), pp. rkaa070. Date of Electronic Publication: 2020 Dec 19 (Print Publication: 2020).
DOI:	10.1093/rap/rkaa070
Abstrakt:	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. (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology.)
Databáze:	MEDLINE
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