OBJECTIVES: Drug survival (time to drug discontinuation) can be interpreted as a composite measure of effectiveness, safety and tolerability. The aim of the present study was to compare the drug survival between adalimumab and etanercept in patients diagnosed with psoriasis (PsO) in Sweden. METHODS: Patients with PsO (ICD-10; L40.0, L40.4-L40.5, and L40.9) starting their first treatment of etanercept or adalimumab between 2009 and 2014 were identified in the publicly available Swedish Drug Prescribed Registry and record-linked to the Swedish National Patient Registry. Data were collected through 31 December 2014. Drug discontinuation was defined as if the patient did not pick upa prescription at the pharmacy for the same treatment within 90, 100 and 120 days after the end of the previous dispensing episode. Kaplan-Meier curves and Cox regression was used with adjustment for sex, calendar year and age at initiation. RESULTS: A total of 3,640 PsO patients were utilizing their first etanercept (48.3%) or adalimumab (51.7%) treatment between 2009 and 2014 in Sweden. There were statistically significant differences in calendar year (p<0.001) and age at initiation (p=0.014), but not for sex (p=0.081) between the two treatments. Drug survival was statistically significant higher for etanercept compared to adalimumab when using 90, 100 but not for 120 days as the definition for discontinuation. Following adjustment for calendar year, sex and age at initiation, the risk of discontinuation was lower in etanercept compared to adalimumab when using 90 and 100 days as the definition time (90 days; HR 0.83, 95% CI 0.76-0.92; 100 days HR 0.86; 95% CI 0.77-0.96; 120 days HR 0.92 95% CI 0.81-1.04). Also, increased age at initiation, calendar year, and male were all independent factors for a lower discontinuation rate. CONCLUSIONS: Drug survival rates were higher for etanercept compared with adalimumab among PsO patients in a nationwide real world setting in Sweden.