Drug survival superiority of tumor necrosis factor inhibitors and interleukin-17 inhibitors over Janus kinase inhibitors and interleukin-12/23 inhibitors in German psoriatic arthritis outpatients: retrospective analysis of the RHADAR database.

Autor:	Strunz PP; Department of Medicine II, Rheumatology/Clinical Immunology, University Hospital of Wuerzburg, Würzburg, Germany., Englbrecht M; Independent Researcher, Greven, Germany., Risser LM; Department of Rheumatology and Immunology, Medical School Hannover, Hannover, Germany., Witte T; Department of Rheumatology and Immunology, Medical School Hannover, Hannover, Germany., Froehlich M; Department of Medicine II, Rheumatology/Clinical Immunology, University Hospital of Wuerzburg, Würzburg, Germany., Schmalzing M; Department of Medicine II, Rheumatology/Clinical Immunology, University Hospital of Wuerzburg, Würzburg, Germany., Gernert M; Department of Medicine II, Rheumatology/Clinical Immunology, University Hospital of Wuerzburg, Würzburg, Germany., Schmieder A; Clinic for Dermatology, Venereology and Allergology, University Hospital Wuerzburg, Wuerzburg, Germany., Bartz-Bazzanella P; Klinik für Internistische Rheumatologie, Rhein-Maas-Klinikum, Würselen, Germany.; Medizinisches Versorgungszentrum, Stolberg, Germany., von der Decken C; Klinik für Internistische Rheumatologie, Rhein-Maas-Klinikum, Würselen, Germany.; Medizinisches Versorgungszentrum, Stolberg, Germany.; Verein zur Förderung der Rheumatologie e.V., Würselen, Germany., Karberg K; Rheumatologisches Versorgungszentrum Steglitz, Berlin, Germany., Gauler G; Private Practitioner, Osnabrück, Germany., Wurth P; Private Practitioner, Osnabrück, Germany., Späthling-Mestekemper S; Rheumapraxis München, Munich, Germany., Kuhn C; Praxis für Rheumatologie, Karlsruhe, Germany., Vorbrüggen W; Verein zur Förderung der Rheumatologie e.V., Würselen, Germany., Heck J; Institute for Clinical Pharmacology, Hannover Medical School, Hannover, Germany., Welcker M; Verein zur Förderung der Rheumatologie e.V., Würselen, Germany.; Medizinisches Versorgungszentrum für Rheumatologie Dr. M. Welcker GmbH, Planegg, Germany., Kleinert S; Department of Medicine II, Rheumatology/Clinical Immunology, University Hospital of Wuerzburg, Würzburg, Germany.; Praxisgemeinschaft Rheumatologie-Nephrologie, Erlangen, Germany.
Jazyk:	angličtina
Zdroj:	Frontiers in immunology [Front Immunol] 2024 May 23; Vol. 15, pp. 1395968. Date of Electronic Publication: 2024 May 23 (Print Publication: 2024).
DOI:	10.3389/fimmu.2024.1395968
Abstrakt:	Objective: Treatment options with disease-modifying antirheumatic drugs (DMARDs) for psoriatic arthritis (PsA) have evolved over recent years. In addition to Janus kinase inhibitors (JAKi), four classes of biologic DMARDs (bDMARDs; interleukin [IL]-23 inhibitors [IL-23i], IL-12/23 inhibitors [IL-12/23i], tumor necrosis factor inhibitors [TNFi], and IL-17 inhibitors [IL-17i]) are currently approved for moderate to severe PsA treatment. There is minimal evidence of the persistence of these drugs among PsA outpatients in a real-world scenario during the period following the approval of JAKi. Therefore, we aimed to analyze the drug survival rates of biologic and JAKi therapies among German PsA outpatients during routine clinical care. Methods: We retrospectively analyzed PsA patients with a new prescription for a biologic or JAKi in the RHADAR database between January 2015 and October 2023. Kaplan-Meier Curves and Cox regression modelling were used to compare drug survival rates. Results: 1352 new prescriptions with bDMARDs (IL-12/23i [n=50], IL-23i [n=31], TNFi [n=774], IL-17i [n=360]) or JAKi (n=137) were identified. The 5-year drug survival rate was 67.8% for IL-17i, 62.3% for TNFi, 53.3% for JAKi, and 46.0% for IL-12/23i. Discontinuation probabilities for JAKi and IL-12/23i were significantly higher compared with TNFi (JAKi hazard ratio [HR] 1.66, [95% CI 1.23-2.24], p=0.001; IL-12/23i HR 1.54, [95% CI 1.02-2.33], p=0.042) and IL-17i (JAKi HR 1.77, [95% CI 1.27-2.47], p=0.001; IL-12/23i HR 1.64, [95% CI 1.06-2.55], p=0.027). JAKi-treated patients had more severe disease and more osteoarthritis (OA) compared to TNFi and more OA compared to IL-17i. Conclusion: German PsA outpatients might persist longer with TNFi and IL-17i compared with IL-12/23i or JAKi. For TNFi, differences in subgroup characteristics and comorbidities (OA) may have affected drug survival rates. For IL-17i, the longer drug survival might not only be related to less OA compared to JAKi and, therefore, might be affected by other factors. Competing Interests: P-PS received speaker’s fees and travel grants from Janssen-Cilag Galapagos, Eli Lilly, Boehringer/Ingelheim and AbbVie less than $10,000 each as well as research funding from Chugai 25000$. ME received payment for data analysis from RHADAR and consulting fees from Abbvie and RHADAR as well as speaker fees and honoraria for lectures from Sanofi, Swedish orphan Biovitrum and Abbvie. ME leadership or fiduciary role from Chugai. LR declares that he has received travel and meeting support from Abbvie and Boehringer and speaking fees from Novartis. TW received honoraria for lectures from Abbvie, Amgen, BMS, Celgene, Fresenius Kabi, Galapagos, Janssen, Lilly, Medac, MSD, Novartis, Pfizer, UCB. MF received speaker’s fees, travel grants or compensation for board memberships from AbbVie, Amgen, AstraZeneca, Novartis, Janssen, Hexal, Pfizer, Takeda, UCB and Eli Lilly. MS received speaker’s fees, travel grants, research funding, or compensation for consultancies or board memberships from AbbVie, Actelion, AstraZeneca, BMS, Boehringer/Ingelheim, Celgene, Chugai/Roche, Eli Lilly, Genzyme, Gilead, Hexal/Sandoz, Janssen-Cilag, MSD, Novartis, Pfizer, Sanofi Pasteur, Takeda Shire, UCB less than $ 10,000 each. MG received travel grants, compensation for advisory boards or speaker’s fees from AbbVie, Chugai, Eli Lilly, Hexal, Janssen, Novartis, Pfizer, Takeda. SS-M received speaker fees from Abbvie, Astra Zeneca, Boerhringer-Ingelheim, BMS, Galapagos, GSK, Lilly, MSD, Novartis, Pfizer, Sanofi, UCB. SK received grants from Abbvie, Novartis, and sparrow for phase 2/3 clinical trials and consulting or speaker fees from Abbvie, Celgene, Chugai, Galapagos, Novartis, and Siemens Healthineers. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Strunz, Englbrecht, Risser, Witte, Froehlich, Schmalzing, Gernert, Schmieder, Bartz-Bazzanella, von der Decken, Karberg, Gauler, Wurth, Späthling-Mestekemper, Kuhn, Vorbrüggen, Heck, Welcker and Kleinert.)
Databáze:	MEDLINE
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