AMGEVITA((R)) persistence in patients with plaque psoriasis: a retrospective database analysis from the British Association of Dermatologists Biologics and Immunomodulators Register

Abstract While multiple studies have evaluated the persistence of biologic agents in patients with plaque psoriasis (Yiu ZZN, Becher G, Kirby B et al. Drug survival associated with effectiveness and safety of treatment with guselkumab, ixekizumab, secukinumab, ustekinumab and adalimumab in patients with psoriasis. JAMA Dermatol 2022; 158:1131–41), persistence data for adalimumab biosimilars are limited. From BADBIR, we assessed AMGEVITA persistence in UK patients aged ≥ 18 years with a diagnosis of chronic plaque psoriasis, who had received at least one dose of AMGEVITA between October 2018 and July 2021 with at least 6 months of follow-up. Study outcomes included AMGEVITA persistence at 6, 12, 18 and 24 months (primary); reasons for AMGEVITA discontinuation (secondary) and Psoriasis Area Severity Index (PASI) score from baseline to 6 months after AMGEVITA start date (exploratory). Outcomes were analysed overall and separately for biologic-experienced (transitioned to AMGEVITA from another biologic) vs. biologic-naïve (started AMGEVITA with no prior biologics) patients. Persistence was defined as the continuous use of AMGEVITA from first administration to discontinuation using a permissible gap of < 90 days assessed using Kaplan–Meier survival methodology. Of 1432 eligible patients, most (n = 1,183; 82.6%) were biologic experienced, 40.1% (n = 574) were female and 56% were aged 35–54 years. At AMGEVITA initiation, mean (SD) time since psoriasis diagnosis overall was 25.4 (12.9) years, and 20.6 (12.6) and 26.6 (12.7) years in biologic-naïve and biologic-experienced patients, respectively; mean (SD) PASI was 8.1 (8.7) in the overall population, and 14.8 (7.6) and 3.2 (5.6) in biologic-naïve and biologic-experienced patients, respectively. Overall, AMGEVITA persistence at 6, 12, 18 and 24 months was 0.94 [95% confidence interval (CI) 0.93–0.95], 0.87 (95% CI 0.86–0.89), 0.84 (95% CI 0.82–0.86) and 0.82 (95% CI 0.80–0.84), respectively; 17.7% (n = 253) of patients discontinued AMGEVITA and mean (SD) time to discontinuation was 9.4 (6.0) months. The most common reasons for AMGEVITA discontinuation were ineffectiveness (n = 102; 40.3%) and adverse events (n = 74; 29.2%). Persistence at 6, 12, 18 and 24 months was higher in biologic-experienced patients than in biologic-naïve patients: 0.94 (95% CI 0.92–0.95), 0.88 (95% CI 0.86–0.90), 0.85 (95% CI 0.83–0.87) and 0.84 (95% CI 0.81–0.86) vs. 0.94 (95% CI 0.91–0.97), 0.84 (95% CI 0.78–0.88), 0.77 (95% CI 0.71–0.82) and 0.74 (95% CI 0.68–0.80), respectively. Mean (SD) time to AMGEVITA discontinuation was similar in biologic-naïve and biologic-experienced patients: 9.0 (6.1) and 10.5 (5.6) months, respectively. Among patients with non-missing data (n = 94 in both groups), mean (SD) change in PASI score at 6 months was −11.3 (8.6) in biologic-naïve and −1.0 (4.4) in biologic-experienced patients. In conclusion, patients with chronic plaque psoriasis initiating AMGEVITA in UK clinical practice demonstrated high drug persistence over 2 years, irrespective of prior biologic use. Funding sources: this analysis was funded by Amgen.