Real-World Treatment Persistence with Biologic Disease-Modifying Antirheumatic Drugs Among German Patients with Psoriatic Arthritis—A Retrospective Database Study

Autor(en)

Philipp Sewerin, Kathrin Borchert, Dominic Meise, Matthias Schneider, Jörg Mahlich

Abstrakt

Introduction: To investigate drug survival for biologic disease-modifying antirheumatic drugs (bDMARDs) in a real-world cohort of German adult biologic-naïve patients with psoriatic arthritis (PsA). Methods: Claims data for patients with a diagnosis of PsA, a bDMARD claims record (index date) between 1 January 2014 and 31 December 2017, and no bDMARD prescription for 365 days before the index date were retrospectively analyzed. The primary outcomes were the overall and individual bDMARD persistence rates over 12 months. Nonpersistence was defined as a treatment gap exceeding the days of supply plus 60 days or switching to a bDMARD other than the index therapy. Sensitivity analysis was performed, wherein the treatment gap was found to vary depending on the bDMARD regimen. Kaplan–Meier curves were plotted to determine persistence; the log-rank test was used to evaluate differences in the persistence rate. Factors associated with treatment discontinuation were evaluated using Cox regression analysis. Results: Among 10,954 patients with a PsA diagnosis, 348 were eligible. The overall bDMARD persistence rate was 57.5%; individual bDMARD persistence rates were 81.3% for ustekinumab, 66.7% for infliximab, and 60.0% for golimumab. The mean (SD) overall persistence with bDMARDs was 289 (103) days; the mean persistence was 334 (72) days for ustekinumab, 309 (82) days for golimumab, and 305 (92) days for infliximab. The main reasons for nonpersistence were switching to another bDMARD (15.8%) and treatment discontinuation (26.7%). Male gender was significantly associated with a lower risk of treatment discontinuation (hazard ratio 0.54, 95% confidence interval 0.39–0.77; P < 0.001). The sensitivity analysis yielded similar results. Conclusion: The one-year persistence rate for bDMARDs in German PsA patients is modest, although the persistence rate depends on the bDMARD considered.

Organisation(en)

Externe Organisation(en)

Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Xcenda GmbH, Janssen-Cilag GmbH

Journal

Rheumatology and Therapy

Band

8

Seiten

483-497

Anzahl der Seiten

15

ISSN

2198-6576

DOI

https://doi.org/10.1007/s40744-021-00286-z

Publikationsdatum

03-2021

Peer-reviewed

Ja

ÖFOS 2012

303010 Gesundheitsökonomie

Schlagwörter

ASJC Scopus Sachgebiete

Rheumatology, Immunology and Allergy

Link zum Portal

https://ucrisportal.univie.ac.at/de/publications/957151e7-2032-4be1-aee3-e00cd52da2c9