OBJECTIVES: To compare adherence and treatment persistence over 12 months among biologic naïve adults initiating apremilast or biologics for the treatment of psoriasis (PsO) in the United States.

METHODS: Adult PsO patients initiating apremilast or biologics (index date) were identified in the January 2013 - June 2016 Truven Health MarketScan Research Databases. Patients were required to be apremilast/biologic naïve at index; 12 months of pre- and post-index continuous enrollment were required. Biologic users were matched up to 2:1 to apremilast users. Treatment persistence was defined as continuous treatment without (1) a >60-day gap in therapy, or (2) a switch to a different PsO treatment during the 12-month post-index period. Patients were adherent if their medication possession ratio (MPR) was ≥80% while persistent on the index treatment.

RESULTS: Matched samples of 703 PsO patients initiating apremilast and 1378 PsO patients initiating biologics were evaluated (mean age 49 years, approximately 50% female, mean Charlson score 0.4). Treatment persistence at 12 months was similar for PsO patients initiating apremilast compared to patients initiating biologics (44.4% vs 44.6%; p=0.914). Patients initiating apremilast were less likely to be non-persistent because of switching (6% vs 11%; p=0.003) and more likely to be non-persistent because of a >60-day gap in therapy (94% vs 89%; p=0.003) compared to patients initiating biologics. Persistence-based MPRs were similar for patients initiating apremilast compared to patients initiating biologics (0.86 vs 0.86; p=0.654) as were adherence rates (73% and 74%; p=0.516).

CONCLUSIONS: Treatment persistence at 12 months and adherence were similar for biologic naïve PsO patients initiating apremilast or biologics in a large U.S. administrative claims database. Non-persistence due to switching was significantly lower for biologic naïve PsO patients initiating apremilast. Future research should describe the healthcare utilization and cost outcomes associated with these treatments.