Study Finds Women are More Likely to Discontinue DMARD Therapy for Psoriasis, Psoriatic Arthritis

Researchers conducted a real-world study to assess gender differences in discontinuation, comorbidities, and comedications in patients with psoriasis and psoriatic arthritis (PsA) who initiated biologic disease-modifying anti-rheumatic drug (bDMARD) and targeted synthetic DMARD (tsDMARD) therapies. They found that rates of bDMARD and tsDMARD discontinuation were higher in women. The results of the study were published as part of the American Academy of Dermatology Virtual Meeting Experience 2020.

Researchers conducted a retrospective cohort study using the United States Optum electronic health record database with integrated claims data from January 1, 2007, to June 30, 2018.

Adult patients with no index bDMARD or tsDMARD exposure who had a claim for psoriasis or PsA in the 12-month baseline period prior to index were included. Patients also had continuous medical and pharmacy enrollment for a 12-month baseline period and 15 months of follow-up.

In the study, bDMARDs encompassed adalimumab, certolizumab pegol, etanercept, infliximab, ixekizumab, golimumab, ustekinumab, and secukinumab, while tsDMARDs included apremilast. Discontinuation was defined as more than 90 days without the index bDMARD/tsDMARD.

The study included 1,769 patients with psoriasis (915 men) and 961 with PsA (457 men). The most common index treatments for both psoriasis and PsA cohorts were adalimumab and etanercept. There were no observed differences in treatment distribution between men and women.

Treatment discontinuation at 12 months was 50% or greater in both patients with psoriasis and PsA, and this varied based on treatment type. Predictors of treatment discontinuation included female sex and baseline depression for patients with both psoriasis and PsA.

Topical corticosteroids, methotrexate, non-steroidal anti-inflammatory drugs, and opioids were common medications used at baseline, and opioid use was high across both indications. Anxiety, depression, and fatigue were more common in women, as were comorbidities and opioids use.

Grabich S, Sheahan H, Baxter R, et al. Higher Prevalence of Comorbidities, Comedications and Biologic Discontinuation in Female Psoriasis Patients in the Real-World. Presented during the AAD Virtual Meeting Experience 2020, June 12-14, 2020.