Comparison of Switching Patterns Among Patients with Psoriasis Using Ixekizumab or Secukinumab in Real-World Settings
Author(s)
Blauvelt A1, Shi N2, Somani N3, Kern S3, Atiya B3, Burge R4, Ridenour T3, Zhu B3, Zimmerman N2, Murage M5
1Oregon Medical Research Center, Portland, IN, USA, 2IBM Watson Health, Acton, MA, USA, 3Eli Lilly and Company, Indianapolis, IN, USA, 4Eli Lilly and Company, Indianapolis, USA; Division of Pharmaceutical Sciences, University of Cincinnati, Indianapolis, IN, USA, 5Eli Lilly and Company, Fishers, IN, USA
OBJECTIVES: To compare switching patterns among a US population of patients with psoriasis prescribed ixekizumab (IXE) or secukinumab (SEC) over 18 months of follow-up. METHODS: A retrospective observational study was conducted using the IBM MarketScan® database (1 March 2015 to 31 July 2019). Patients diagnosed with psoriasis, aged ≥18 years, and treated with IXE or SEC were included. Switching was defined as having a new biologic for psoriasis from the index drug (IXE or SEC) during the follow-up period. The date of the first new biologic claim set the switching date. Patients were further stratified into biologic-naive and biologic-experienced cohorts based on biologic use in the 6-month pre-period. Inverse probability of treatment weighting (IPTW) was used to address cohort imbalances. Cox-proportional hazards models were used to estimate switching risk. RESULTS: A total of 747 IXE users and 1508 SEC users were included. Switching rates were similar between the overall IXE vs. SEC cohorts (24.5% vs. 27.2%, p=0.168) and biologic-naive sub-cohort (22.0% vs. 19.7%, p=0.390), but were significantly lower among biologic-experienced IXE vs. SEC users (26.6% vs. 34.0%; p=0.009), after weighting with IPTW. After multivariable adjustment, the risk of switching was significantly lower among biologic-experienced IXE users compared with SEC users (HR=0.75, 95% CI [0.60–0.93]; p=0.011), but not significantly different among the overall patient cohort (HR=0.88, 95% CI [0.74–1.05]; p=0.167) and biologic-naive sub-cohort (HR=1.16, 95% CI [0.88 –1.54]; p=0.294). CONCLUSIONS: In this real-world study of patients with psoriasis, switching rate and switching risk were lower among biologic-experienced IXE users than their SEC-treated counterparts. Biologic-experienced patients tend to be more treatment-refractory. Among biologic-naive and combined cohorts, there were no statistically significant differences in switching. These findings may inform healthcare practitioners in making biologic treatment decisions, particularly among patients with previous biologic experience where treatment may be more challenging.
Conference/Value in Health Info
2021-05, ISPOR 2021, Montreal, Canada
Value in Health, Volume 24, Issue 5, S1 (May 2021)
Code
PBI17
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance, Disease Management, Treatment Patterns and Guidelines, Value of Information
Disease
Biologics and Biosimilars