TY - JOUR

T1 - Mapping the road to biologics in psoriasis and psoriatic arthritis

T2 - A nationwide drug utilization study

AU - Thein, David

AU - Rosenø, Nana A. L.

AU - Nielsen, Mia-Louise

AU - Kristensen, Lars Erik

AU - Maul, Julia-Tatjana

AU - Wu, Jashin J.

AU - Thomsen, Simon Francis

AU - Thyssen, Jacob P.

AU - Egeberg, Alexander

N1 - Publisher Copyright: © 2023 The Authors. JEADV Clinical Practice published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.

PY - 2023

Y1 - 2023

N2 - Background: Limited research has been conducted on whether advances in novel biologics and biosimilars have improved the treatment journey preceding biologics. Objectives: To map the overall treatment journey preceding the initiation of first biologic therapy in patients with psoriasis (PsO) and psoriatic arthritis (PsA), as well as the changes over time. Methods: Using Danish nationwide registries, we included all patients treated with a first-time biologic (2010–2018) for either PsO or PsA and reported the medical treatment journey. We used Sankey diagrams to illustrate the flow of treatment series. Results: The study included 2082 patients with PsO (62.5% male) and 1831 patients with PsA (42.3% male). Before biologics, 49.5% treated for PsO and 36.8% treated for PsA received ≥2 type therapies and 59.3% with PsO and 25.5% with PsA received ≥3 treatment series. Median time from first systemic therapy to a biologic was 3.9 years (Q1–Q3, 1.3–4.1) for PsO and 2.1 years (Q1–Q3, 0.6–5.8) for PsA. The majority of patients with PsO (1174 [56.4%]) received multiple treatment series with the same drug, while almost a third of patients with PsA (572 [31.2%]) did the same. Twelve percent of patients with PsO and 6.4% of patients with PsA repeated treatment with a drug they had already stopped for an alternative treatment. Conclusions: Although most patients are adequately managed, our findings suggest the possibility of a yet too long and complicated treatment journey before starting biologics.

AB - Background: Limited research has been conducted on whether advances in novel biologics and biosimilars have improved the treatment journey preceding biologics. Objectives: To map the overall treatment journey preceding the initiation of first biologic therapy in patients with psoriasis (PsO) and psoriatic arthritis (PsA), as well as the changes over time. Methods: Using Danish nationwide registries, we included all patients treated with a first-time biologic (2010–2018) for either PsO or PsA and reported the medical treatment journey. We used Sankey diagrams to illustrate the flow of treatment series. Results: The study included 2082 patients with PsO (62.5% male) and 1831 patients with PsA (42.3% male). Before biologics, 49.5% treated for PsO and 36.8% treated for PsA received ≥2 type therapies and 59.3% with PsO and 25.5% with PsA received ≥3 treatment series. Median time from first systemic therapy to a biologic was 3.9 years (Q1–Q3, 1.3–4.1) for PsO and 2.1 years (Q1–Q3, 0.6–5.8) for PsA. The majority of patients with PsO (1174 [56.4%]) received multiple treatment series with the same drug, while almost a third of patients with PsA (572 [31.2%]) did the same. Twelve percent of patients with PsO and 6.4% of patients with PsA repeated treatment with a drug they had already stopped for an alternative treatment. Conclusions: Although most patients are adequately managed, our findings suggest the possibility of a yet too long and complicated treatment journey before starting biologics.

KW - acitretin

KW - azathioprine

KW - biologics

KW - cyclosporine

KW - dimethylfumarate

KW - hydroxychloroquine

KW - leflunomide

KW - methotrexate

KW - MTX

KW - phototherapy

KW - psoriasis

KW - psoriatic arthritis

KW - sulfasalazine

KW - treatment journey

U2 - 10.1002/jvc2.194

DO - 10.1002/jvc2.194

M3 - Journal article

AN - SCOPUS:85181518167

VL - 2

SP - 857

EP - 863

JO - JEADV Clinical Practice

JF - JEADV Clinical Practice

SN - 2768-6566

IS - 4

ER -