Drug survival for biologics in psoriasis patients: real world evidence for Greece during the period 2016-2020

Abstract

Abstract Background Drug persistence is a crucial aspect of treatment success in psoriasis. Objectives The scope of this manuscript is to record real-world evidence concerning drug survival of biologic agents used for psoriasis treatment and to detect associated modifying factors in Greece. Methods This was a retrospective cohort study based on data extracted from the nationwide Greek prescription system. Psoriatic patients, with or without concomitant psoriatic arthritis (PsA), that had initiated biologics between January 1st 2016 and December 31st 2020 were included. Results We included 8,819 patients who received 13,359 treatment lines. Among them, 76.8% were biologic naïve patients and 16.5% were diagnosed with concomitant PsA. The overall median drug survival was 34.3 (95% CI: 32.6-36.5) months. Drug persistence at 12, 24, 36 and 48 months of follow-up was 71.9%, 57.7%, 49.0% and 43.7%, respectively. Patients receiving brodalumab had the highest drug survival rate in the first two years, while secukinumab had the highest rates beyond this period. Overall, drug survival rates were higher in the 1st [median, 51.1 (95% CI: 47.1, not reached (NR) months] compared to the 2nd treatment line and onwards [median, 21.7 (95% CI: 20.0, 23.5) months]. Treatment line, PsA status, age and sex were found to significantly affect drug survival rates. Conclusions Our findings confirm previous reports regarding the importance of efficient 1st line biologics and the vulnerability of patients to co-existent PsA. The utilitzation of antibodies against interleukins confer to high drug survival rates. These results will assist clinical management of psoriasis patients in Greece.