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What Biologics Offer the Best Treatment Persistence for Psoriatic Disease?

Treatment persistence high with IL-17 inhibitors versus TNF inhibitors for psoriasis, psoriatic arthritis patients

By Dermsquared Editorial Team | March 23, 2022

For patients with psoriasis (PsO) and psoriatic arthritis (PsA), interleukin 17 (IL-17) inhibitors are associated with higher treatment persistence than tumor necrosis factor (TNF) inhibitors, according to a study published online March 23 in JAMA Dermatology .

Laura Pina Vegas, M.D., from the Université Paris Est Créteil in France, and colleagues examined the long-term persistence of different biologic classes to treat PsO and PsA using data for all adults with PsO and PsA who were new users of biologics from Jan. 1, 2015, to May 31, 2019. The analyses included 16,892 patients with PsO and 6,531 with PsA.

The researchers found that 60.4 percent of the PsO patients started therapy with a TNF inhibitor; 23.6 percent started with an interleukin 12 and interleukin 23 (IL-12/23) inhibitor; and 16.0 percent started with an IL-17 inhibitor. Of the PsA patients, 76.2, 12.3, and 11.5 percent started treatment with a TNF inhibitor, IL-12/23 inhibitor, and IL-17 inhibitor, respectively. For PsO and PsA, the overall three-year persistence rates were 40.9 and 36.2 percent, respectively. For PsO and PsA, higher persistence was seen with the IL-17 inhibitor versus the TNF inhibitor (weighted hazard ratios, 0.78 and 0.70, respectively); for PsA, persistence was higher for the IL-17 inhibitor versus the IL-12/23 inhibitor (weighted hazard ratio, 0.69). For PsO, but not PsA, the IL-12/23 inhibitor was associated with higher persistence than the TNF inhibitor (weighted hazard ratio, 0.76).

"Given the many biologic treatment options available in the modern therapeutic environment, our results may help physicians optimize first-line treatment pathways," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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