OBJECTIVES:  Currently, no comparative data have been published on the persistence among biologic-naive patients with psoriasis who are being treated with apremilast vs. etanercept in a real-world setting. We assessed real-world treatment persistence over 12 months in patients with psoriasis in the United States who were initiated on apremilast or etanercept. METHODS:  This descriptive, observational, retrospective cohort study was conducted using MarketScan Commercial and Medicare Supplemental Databases (2013-2016). Adults with ≥2 diagnosis codes for psoriasis (ICD-9: 696.1; ICD-10: 40.0) who were initiated on apremilast or etanercept treatment were selected. The index date was defined as the first apremilast or etanercept prescription date, and patients were required to be continuously enrolled for ≥12 months pre-index and ≥12 months post-index. Time to treatment discontinuation was evaluated descriptively using Kaplan-Meier curves, and defined as the end of days’ supply before at least a 60-day gap without medication. At 12 months post-index, the percentage of patients persisting on drug was assessed. RESULTS:  A total of 1,101 patients initiated on apremilast treatment and 687 initiated on etanercept treatment met the inclusion criteria and had similar baseline characteristics. Mean enrollment follow-up time was 493 days for apremilast and 586 days for etanercept. At 12 months post-index, persistence on the initiated drug was not significantly different between the apremilast and etanercept cohorts (39.5% [apremilast] vs. 35.8% [etanercept]; P=0.109). CONCLUSIONS: While apremilast showed numerically higher treatment persistence compared with etanercept, the difference was not statistically significant. Further analyses are needed to explore the impact of higher persistence on clinical effectiveness, that is, to describe the benefit patients are receiving from staying on treatment.