Drug survival of biologic treatments for psoriasis and psoriatic arthritis in Denmark, 2018-23

BACKGROUNDPsoriasis is a chronic inflammatory skin condition. It is being increasingly treated with biologic agents targeting specific immune pathways. These treatments target specific immune system pathways involved in the disease. Drug survival (how long patients remain on a given treatment) is a key measure of long-term effectiveness and safety.

OBJECTIVESTo analyse the drug survival rates of approved biologics for psoriasis using Danish nationwide register-based data from 2018 to 2023.

METHODSThis study used a nationwide register-based cohort of patients diagnosed with psoriasis in Denmark who were treated with biologics between 2018 and 2023. Patients were stratified by the presence or absence of psoriatic arthritis (PsA). Drug survival was assessed using Kaplan-Meier curves, and the rate of discontinuation was analysed using Cox proportional hazards regression models.

RESULTSOf the biologics studied, infliximab had the highest 1-year drug survival (49%), followed by ustekinumab (42%). Bimekizumab, the most recently introduced biologic in Denmark, had a 19% drug survival rate after 349 days. Ustekinumab had longer persistence in patients who only had psoriasis, but the drug survival rate was reduced in patients with PsA. In contrast, infliximab maintained robust performance across both patient groups, with a significantly lower risk of discontinuation compared with ustekinumab (hazard ratio 0.59, 95% confidence intervals 0.53-0.67), particularly in patients with PsA.

CONCLUSIONSDrug survival differed across biologic treatments and according to PsA status. Infliximab had higher overall drug survival, particularly in patients with PsA. Ustekinumab had greater treatment persistence in patients without PsA but lower drug survival in those with PsA.

Abstract from PubMed