Comparison of Persistence Rates: Tildrakizumab vs. Adalimumab/Ustekinumab Based on a German Longitudinal Prescription Database (LRx) of Social Health Insurance Patients in Outpatient Care
Author(s)
Buelent Akmaz1, MARIA ANGELES LOPEZ PONT, MsC2, Astrid Kirsch, Dr.3, Elena Savtcheva, MsC3, Ximena Orozco Ruiz, Dr.4, Silvia Kruppert, MsC4.
1Global Market Access, Almirall, Barcelona, Spain, 2ALMIRALL SA, Barcelona, Spain, 3Almirall, Hamburg, Germany, 4IQVIA, Frankfurt, Germany.
1Global Market Access, Almirall, Barcelona, Spain, 2ALMIRALL SA, Barcelona, Spain, 3Almirall, Hamburg, Germany, 4IQVIA, Frankfurt, Germany.
OBJECTIVES: Tildrakizumab, an interleukin IL-23p19 inhibitor, has demonstrated effectiveness and safety in treating moderate to severe psoriasis (PsO). Nonetheless, long-term comparative data, valuable for decision-makers such as clinicians and payers, are limited. This study aims to evaluate the persistence of Tildrakizumab in German PsO outpatients and compare it with well-established biologics: the TNF-alpha inhibitor Adalimumab and the IL-12/23 inhibitor Ustekinumab
METHODS: This longitudinal study utilized data from the IQVIA™ LRx database, a German representative database covering approximately 80% of social health insurance prescriptions in retail pharmacies. The study included PsO patients (≥18 years) who were prescribed Tildrakizumab, Adalimumab or Ustekinumab between May 2019 and June 2023. A validated in-house machine-learning model, trained on the IQVIA™ Disease Analyzer electronic medical records, was used to identify PsO patients in the IQVIA™ LRx database. Drug persistence, defined as the time from treatment initiation to discontinuation, showed the proportion of patients remaining on the initial therapy. A 180-day grace period was applied to account for real-world prescription refill delays, based on the specified SmPC posology. Drug persistence in bio-naïve and bio-experienced patients was analyzed using Kaplan-Meier curves and compared with a log-rank test. Adalimumab and Ustekinumab were pooled for the analysis, and bio-experienced classification included prior use of any PsO-approved biologic
RESULTS: Among Tildrakizumab patients, 3,282 were bio-naïve and 2,035 bio-experienced; for Adalimumab/Ustekinumab, 5,963 were bio-naïve and 2,206 bio-experienced. After twelve months, Tildrakizumab demonstrated significantly higher persistence than Adalimumab/Ustekinumab in both bio-naïve (74.3% vs. 51.8%) and bio-experienced (60.0% vs. 46.6%) patients. This trend continued at four years (bio-naïve: 43.9% vs. 22.3%; bio-experienced: 28.3% vs. 19.7%)
CONCLUSIONS: After a four-year follow-up, PsO patients treated with Tildrakizumab showed higher persistence compared to those treated with Adalimumab/Ustekinumab, particularly among bio-naïve patients. This underscores the long-term sustained efficacy of Tildrakizumab for PsO patients in the German outpatient setting.
METHODS: This longitudinal study utilized data from the IQVIA™ LRx database, a German representative database covering approximately 80% of social health insurance prescriptions in retail pharmacies. The study included PsO patients (≥18 years) who were prescribed Tildrakizumab, Adalimumab or Ustekinumab between May 2019 and June 2023. A validated in-house machine-learning model, trained on the IQVIA™ Disease Analyzer electronic medical records, was used to identify PsO patients in the IQVIA™ LRx database. Drug persistence, defined as the time from treatment initiation to discontinuation, showed the proportion of patients remaining on the initial therapy. A 180-day grace period was applied to account for real-world prescription refill delays, based on the specified SmPC posology. Drug persistence in bio-naïve and bio-experienced patients was analyzed using Kaplan-Meier curves and compared with a log-rank test. Adalimumab and Ustekinumab were pooled for the analysis, and bio-experienced classification included prior use of any PsO-approved biologic
RESULTS: Among Tildrakizumab patients, 3,282 were bio-naïve and 2,035 bio-experienced; for Adalimumab/Ustekinumab, 5,963 were bio-naïve and 2,206 bio-experienced. After twelve months, Tildrakizumab demonstrated significantly higher persistence than Adalimumab/Ustekinumab in both bio-naïve (74.3% vs. 51.8%) and bio-experienced (60.0% vs. 46.6%) patients. This trend continued at four years (bio-naïve: 43.9% vs. 22.3%; bio-experienced: 28.3% vs. 19.7%)
CONCLUSIONS: After a four-year follow-up, PsO patients treated with Tildrakizumab showed higher persistence compared to those treated with Adalimumab/Ustekinumab, particularly among bio-naïve patients. This underscores the long-term sustained efficacy of Tildrakizumab for PsO patients in the German outpatient setting.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
CO62
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Sensory System Disorders (Ear, Eye, Dental, Skin), Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)