LONG-TERM PERSISTENCE OF FIRST-LINE BIOLOGICS FOR PSORIATIC ARTHRITIS AND PSORIASIS: A COHORT STUDY OF 23423 PATIENTS FROM THE FRENCH HEALTH INSURANCE DATABASE (SNDS)
Authors: Pina Vegas L et al.
This cohort study is based on the administrative healthcare database of the French health insurance linked to hospital discharges between 2015 and 2019. Patients with PsA and PsO with new use of biologic therapies were included. 6531 patients with PsA (mean age 49 + 13 yrs, 45% male) were treated with: TNFi in 76%, IL12/23i in 12% and IL17i in 12%. 16892 patients with PsO were included (mean age 53 + 17 yrs, 50% male) and received: TNF inhibitor 60%, IL12/23i in 24% and IL-17i in 16%. Overall persistence rates were 36% and 41% for PsA and PsO. IL17i were associated with higher persistence than TNFi for PsA (weighted HR 0.70, 95%CI 0.58-0.85) and PsO (HR 0.78, 95%CI 0.73-0.83) and IL12/23i for PsA (HR 0.69, 95%CI 0.55-0.87). No difference was found for IL12/23i and IL17i for PsO. IL12/23i had better persistence for PsO than TNFi.
The treatment armamentarium for PsA has increased significantly but data on long-term treatment persistence is scarce. This real-life cohort analysis suggests a higher persistence for IL17i than TNFi for PsA and PsO in patients who newly start a biologic. A limitation is probably the fact that this data is based on hospital discharge and questions whether this is representative. Of note overall persistence of all biologics was low, the reason for this being unclear.