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Psoriasis patients utilizing secukinumab, ixekizumab, or brodalumab – comparisons to prior biologic medication adherence levels, reasons for switching, and reported changes in disease symptoms

Background: Since the approval of interleukin-17 (IL-17) inhibitors to treat psoriasis progression, an increasing number of patients have switched to these third-generation biologics (i.e. secukinumab, ixekizumab, or brodalumab). Little is known about the impact of the new therapy choices upon patie...

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Autores principales: Baiano, Renee, Staskon, Francis, Miller, Rick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764379/
http://dx.doi.org/10.1080/21556660.2019.1658298
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author Baiano, Renee
Staskon, Francis
Miller, Rick
author_facet Baiano, Renee
Staskon, Francis
Miller, Rick
author_sort Baiano, Renee
collection PubMed
description Background: Since the approval of interleukin-17 (IL-17) inhibitors to treat psoriasis progression, an increasing number of patients have switched to these third-generation biologics (i.e. secukinumab, ixekizumab, or brodalumab). Little is known about the impact of the new therapy choices upon patient adherence, reasons for switching, or patient reported impacts. Aims: Describe pharmacy utilization for IL-17 inhibitors, and investigate differences from prior biologic treatments (i.e. adalimumab, ustekinumab, or etanercept) on associated medication adherence levels, or patient reported reasons for switching and current disease symptoms after switching. Methods: Pharmacy records from a national specialty pharmacy were examined retrospectively for patients starting an IL-17 inhibitor from January 2016–December 2017, as well as their biologic treatment in the prior 12-months (i.e. adalimumab, ustekinumab, or etanercept). In addition, patient reported information from the clinical management platform was included for those switching from a prior therapy. A 180 day follow-up period was used after starting the IL-17 inhibitor (till May 31, 2018). The medication adherence outcome was the proportion of days covered (PDC) in the observation period (180 days). Excluded patients were under the age of 18 at the start of the new IL-17 inhibitor, or those residing in a US territory. Results: The study sample of 5,215 consisted of 2,218 (42.5%) switching from a prior treatment. The most frequent IL-17 inhibitor dispensed was secukinumab (76.1%), followed by ixekizumab (23.7%), and the more frequent prior treatments were etanercept (37%) and adalimumab (35.8%). Gender and age distributions were similar across the IL-17 inhibitors. Medication adherence significantly increased after switching 6.4% on average PDC, and patients were 1.56-times more likely to be adherent (PDC ≥80%); after adjusting for age, gender, census location, and provider specialty. In these multivariate models, the only covariate significantly associated to higher adherence was if the provider specialty was in rheumatology. The most common reason reported for switching was “ineffective treatment” (64.7%). After switching to an IL-17 inhibitor, 45.7% of patients report symptoms as “better”, 26.5% the “same”, and only 5.3% state “worse” symptoms. Conclusions: Specialty pharmacies offering the recent IL-17 inhibitors allow for additional treatment options for patients needing alternative therapies.
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spelling pubmed-67643792019-10-08 Psoriasis patients utilizing secukinumab, ixekizumab, or brodalumab – comparisons to prior biologic medication adherence levels, reasons for switching, and reported changes in disease symptoms Baiano, Renee Staskon, Francis Miller, Rick J Drug Assess Poster #2 Background: Since the approval of interleukin-17 (IL-17) inhibitors to treat psoriasis progression, an increasing number of patients have switched to these third-generation biologics (i.e. secukinumab, ixekizumab, or brodalumab). Little is known about the impact of the new therapy choices upon patient adherence, reasons for switching, or patient reported impacts. Aims: Describe pharmacy utilization for IL-17 inhibitors, and investigate differences from prior biologic treatments (i.e. adalimumab, ustekinumab, or etanercept) on associated medication adherence levels, or patient reported reasons for switching and current disease symptoms after switching. Methods: Pharmacy records from a national specialty pharmacy were examined retrospectively for patients starting an IL-17 inhibitor from January 2016–December 2017, as well as their biologic treatment in the prior 12-months (i.e. adalimumab, ustekinumab, or etanercept). In addition, patient reported information from the clinical management platform was included for those switching from a prior therapy. A 180 day follow-up period was used after starting the IL-17 inhibitor (till May 31, 2018). The medication adherence outcome was the proportion of days covered (PDC) in the observation period (180 days). Excluded patients were under the age of 18 at the start of the new IL-17 inhibitor, or those residing in a US territory. Results: The study sample of 5,215 consisted of 2,218 (42.5%) switching from a prior treatment. The most frequent IL-17 inhibitor dispensed was secukinumab (76.1%), followed by ixekizumab (23.7%), and the more frequent prior treatments were etanercept (37%) and adalimumab (35.8%). Gender and age distributions were similar across the IL-17 inhibitors. Medication adherence significantly increased after switching 6.4% on average PDC, and patients were 1.56-times more likely to be adherent (PDC ≥80%); after adjusting for age, gender, census location, and provider specialty. In these multivariate models, the only covariate significantly associated to higher adherence was if the provider specialty was in rheumatology. The most common reason reported for switching was “ineffective treatment” (64.7%). After switching to an IL-17 inhibitor, 45.7% of patients report symptoms as “better”, 26.5% the “same”, and only 5.3% state “worse” symptoms. Conclusions: Specialty pharmacies offering the recent IL-17 inhibitors allow for additional treatment options for patients needing alternative therapies. Taylor & Francis 2019-09-06 /pmc/articles/PMC6764379/ http://dx.doi.org/10.1080/21556660.2019.1658298 Text en © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Poster #2
Baiano, Renee
Staskon, Francis
Miller, Rick
Psoriasis patients utilizing secukinumab, ixekizumab, or brodalumab – comparisons to prior biologic medication adherence levels, reasons for switching, and reported changes in disease symptoms
title Psoriasis patients utilizing secukinumab, ixekizumab, or brodalumab – comparisons to prior biologic medication adherence levels, reasons for switching, and reported changes in disease symptoms
title_full Psoriasis patients utilizing secukinumab, ixekizumab, or brodalumab – comparisons to prior biologic medication adherence levels, reasons for switching, and reported changes in disease symptoms
title_fullStr Psoriasis patients utilizing secukinumab, ixekizumab, or brodalumab – comparisons to prior biologic medication adherence levels, reasons for switching, and reported changes in disease symptoms
title_full_unstemmed Psoriasis patients utilizing secukinumab, ixekizumab, or brodalumab – comparisons to prior biologic medication adherence levels, reasons for switching, and reported changes in disease symptoms
title_short Psoriasis patients utilizing secukinumab, ixekizumab, or brodalumab – comparisons to prior biologic medication adherence levels, reasons for switching, and reported changes in disease symptoms
title_sort psoriasis patients utilizing secukinumab, ixekizumab, or brodalumab – comparisons to prior biologic medication adherence levels, reasons for switching, and reported changes in disease symptoms
topic Poster #2
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764379/
http://dx.doi.org/10.1080/21556660.2019.1658298
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