Treatment Utilization and Treatment Duration of Patients With Psoriasis Diagnosed With Psoriatic Arthritis in a US Commercial Administrative Claims Database

OBJECTIVES: Psoriatic arthritis (PsA) is a common comorbidity for patients with psoriasis (PsO), but treatment use after PsA diagnosis is unknown. This study described the treatment utilization and duration of patients with PsO and comorbid PsA.

METHODS: This retrospective cohort study used an administrative claims database of commercially insured members from January 1, 2016 to December 31, 2022. Members were included if they had ≥2 medical claims, ≥30 days apart, for each PsO and PsA. PsO diagnoses could occur at any point during the study period and PsA diagnoses must have occurred between January 1, 2017 and December 31, 2021, with the first claim for PsA (considered the index claim) coming after the initial PsO diagnosis. Patients were required to have 12-months of pre- and post-index continuous enrollment in medical and pharmacy benefits and be >18 years old at index. Primary outcomes included utilization of branded systemic and oral generic treatments, the average treatment duration, and the mean number of disease-related physician office visits.

RESULTS: A total of 38,301 patients with PsO and PsA were included. The mean (SD) age was 51.0 (11.0) years and 55% of patients in the sample were female. The top 3 most utilized branded systemic and oral generics therapies were apremilast (11.9%), secukinumab (8.3%), and infliximab (2.8%), and methotrexate (25.6%), acitretin (0.3%), and cyclosporine (0.2%). Mean (SD) treatment duration in each treatment was 195.0 (125.9), 207.2 (123.0), and 279.1 (103.0) days for apremilast, secukinumab, and infliximab, respectively, and 69.1 (60.0), 42.8 (30.1), and 54.3 (50.5) days, among the top-3 oral generics, respectively. Patients had 4.6 (3.4) physician office visits on average during the post-index period.

CONCLUSIONS: Branded systemic use among patients with PsO and PsO was common and may offer longer treatment duration compared to oral generics. Providers should consider these treatment options upon comorbid diagnoses.