Treatment adherence and persistence of seven commonly prescribed biologics for moderate to severe psoriasis and psoriatic arthritis in a U.S. commercially insured population

Background: Adalimumab (ADA), certolizumab pegol (CER), etanercept (ETA), guselkumab (GUS), ixekizumab (IXE), secukinumab (SEC), and ustekinumab (UST) are biologics approved for the treatment of psoriasis (PsO) and psoriatic arthritis (PsA). We examined adherence and persistence among PsO patients with comorbid PsA who initiated treatment with any of these biologics.

Methods: Adult patients with ≥1 pharmacy/medical claim for any of these seven biologics, and ≥1 diagnosis of both PsO and PsA were selected from the MarketScan Commercial database (July 2014-June 2019). Adherence and persistence rates were examined among the seven study cohorts during fixed follow-up periods (3, 6, 9, and 12 months).

Results: Among patients with ≥9 months of continuous enrollment, 3,251 initiated ADA, 418 CER, 1,563 ETA, 126 GUS, 422 IXE, 1,596 SEC, and 1,267 UST. During the 9-month follow-up period, the proportions of adherent patients were numerically highest among those treated with GUS (59.5%) and UST (57.0%), followed by SEC (47.9%), IXE (47.6%), ADA (46.8%), ETA (37.4%), and CER (22.0%); persistence rates were also numerically highest among those treated with GUS (65.9%) and UST (65.7%).

Limitations: Adjustment for potential confounders was not conducted.

Conclusions: Adherence and persistence rates were numerically highest among patients who initiated GUS and UST.