Medication Persistence for Psoriatic Arthritis in a Brazilian Real-World Setting

Abstract

Aim: To evaluate the persistence of biological (TNF inhibitor [anti-TNF]) and synthetic (conventional synthetic disease-modifying antirheumatic drugs [csDMARDs]) antirheumatic agents for psoriatic arthritis and their associated factors. Methods: A historical cohort was developed. Persistence and associated factors were evaluated at 6 and 12 months. Results: A total of 161 patients were included. The anti-TNF treatment presented higher persistence as compared with csDMARDs at 6 (83.4 vs 50.8%; p < 0.05) and 12 months (66.4 vs 35.6%; p < 0.05). From anti-TNFs, adalimumab and etanercept presented similar persistence, along with leflunomide and methotrexate among the csDMARDs. The factors associated with non-persistence with regard to anti-TNF agents were female sex and use of infliximab. Conclusion: Anti-TNF agents are important therapeutic alternatives and present lower rates of discontinuation as compared with csDMARDs.

Persistence of biologic treatments in psoriatic arthritis: a population-based study in Sweden

“…Some existing literature reports that time from disease onset is associated with non-persistence, as in the present study [ 8 , 10 , 11 ], although the association magnitude (1–2% risk reduction per year) appears to be small and even non-significant in the case of biologic-experienced patients. The present study found that women have a higher risk of non-persistence, consistent with most other findings [ 10–12 , 14 , 16 , 17 , 19 , 20 ].…”

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

“…The overall 12-month persistence rates observed in the current study (primary analysis: 57.5%; sensitivity analysis: 57.8%) were moderate but were similar to the results of claims data-based studies from Germany (58.7% and 71.4%) [ 13 , 15 ], Brazil (66.4%) [ 14 ], and the US (43.4% and 44.5%) [ 12 , 25 ] covering various time periods, as well as that in a systematic review by Murage et al (61%) [ 26 ]. Although the current study did not evaluate persistence beyond 12 months, previous research has shown that persistence rates decrease with time.…”

“…Consistent with previous research, in the current study, only male gender was observed to be significantly associated with a lower risk of treatment discontinuation in both the primary and sensitivity analyses. Da Silva et al [ 14 ] evaluated a historical cohort of Brazilian patients with PsA who were treated with TNFi and reported that female gender was associated with medication nonpersistence (HR 2.65, 95% CI 1.4–5.0; P = 0.003). Similar results were reported by Stober et al [ 38 ] in a single-center retrospective cohort study of patients with PsA initiating TNFi therapy (HR 2.57, 95% CI 1.3–5.2; P = 0.01).…”

“…Persistence with bDMARDs and tsDMARDs, i.e., the time interval from initiation to discontinuation of treatment [ 11 ], varies with the treatment under investigation and with the type of health center and the country considered [ 12 – 14 ]. In Germany, the persistence rate for patients with PsA who were prescribed biologics was reported to be 57.9% after 1 year [ 13 ] and 33.2% after 5 years [ 15 ].…”

“…However, these persistence rates are for prescriptions of biologics as a class, not for individual biologics. Studies from other countries have reported that persistence rates of biologics that are used to treat PsA vary depending on the drug prescribed at the index date [ 12 , 14 ], but corresponding data for Germany are still awaited, despite their importance for clinical and health economic decision-making. To address this knowledge gap, we evaluated the real-world bMARD persistence rate of patients with PsA using data from a large German claims database.…”