Comparison of Persistence And Adherence In Biologic Naïve Patients With Psoriatic Arthritis Initiating Apremilast or Biologics In A US Administrative Claims Database

Abstract

Objectives: To compare treatment persistence and adherence over one year in biologic naïve psoriatic arthritis (PsA) patients initiating apremilast or biologics using a U.S. administrative claims database. MethOds: This retrospective study selected adult PsA patients initiating apremilast or biologics within the January 2013-June 2016 Truven Health MarketScan claims databases. Patients were required to be apremilast/biologic naïve on the index agent in the 12-month pre-index period and have continuous enrollment in the 12-month pre-and post-index periods (index date = initial apremilast or biologic claim). Biologic users were matched 2:1 to apremilast users. Treatment persistence at 12 months was defined as continuous treatment without (1) a > 60-day gap in therapy or (2) a switch to a different PsA treatment and measured during the 12-month post-index period. Patients were adherent if their medication possession ratio (MPR) was ≥ 80% while persistent on the index agent. Results: A total of 381 patients initiating apremilast were matched to 761 patients initiating biologics. Baseline characteristics were similar in both groups (mean age 51 years, 60% female, mean Charlson score 0.6). Treatment persistence at 12 months for apremilast users was similar to biologic users (43% vs 48%; p= 0.082). Average time to non-persistence was 124 days for apremilast users compared to 132 days for biologics users (p= 0.194). Among non-persistent users, apremilast users and biologic users had similar switch rates (7% vs 9%; p= 0.389) and discontinuation rates (93% vs 91%; p= 0.389). Average persistence-based MPR was 0.870 for apremilast users compared to 0.854 for biologic users (p= 0.056), and the adherence rates were 77% and 73%, respectively (p= 0.175). cOnclusiOns: At 12 months, persistence and adherence as well as drivers of non-persistence were similar for biologic naïve patients initiating apremilast or biologics for the treatment of PsA in the U.S.

Treatment persistence of subcutaneous TNF inhibitors among Australian patients with immune-mediated rheumatic disease (IMRD)

“…In the Netherlands and Britain, TNFi treatments in RA were estimated to have a median persistence time of 3.5 and 3.3 years respectively 21,22. In a study of PsA persistence in the US, biologic naïve patients were estimated to have a median of 32 months, and biologic experienced patients had 23 months 23. An Australian registry study reported overall median persistence between 24.6 months and 33.6 months across RA, AS, PsA, and undifferentiated arthritis 17…”