Real-world switching patterns and associated characteristics in patients with psoriasis treated with biologics in the United States

Abstract

Background: Switching therapies is common for patients with psoriasis. Objective: To quantify real-world switching rates and characteristics among patients initiating biologics over 24 months. Methods: Patients aged ≥18 years with ≥2 confirmed psoriasis diagnoses who initiated a new biologic were identified from a US-payer claims database (Merative® MarketScan®) Switching rates were reported over 24 months using Kaplan–Meier survival analysis, and multivariable Cox regression analyses were performed to identify associated patient characteristics. Results: A total of 7997 patients were included, with overall treatment switch rates at 14.4% at 12 months and 26.0% at 24 months. IL-23 inhibitors were associated with the lowest risk of switching compared with TNF, IL-17, and IL-12/23 inhibitors over 24 months (p < 0.0001). Switch rates varied between specific biologics, with the lowest switch rates observed for patients treated with risankizumab at 8.5% followed by guselkumab at 15.7% over 24 months. Prior targeted immune modulator use, age, and female gender were predictors of switching (adjusted hazard ratio; 1.23, 1.31, and 1.40, respectively; p ≤ 0.0005). Limitations: Claims data may be subject to data errors and reasons for switching cannot be determined. Conclusion: Switching was common in psoriasis patients using biologics over 24 months, with the lowest risk of switching observed with IL-23 inhibitors.