Psoriasis treatment patterns with etanercept and adalimumab in a United States health plan population.
BACKGROUND
A retrospective study utilizing administrative claims from a US commercial health plan was performed to examine etanercept and adalimumab treatment patterns among patients with psoriasis (PSO).


METHODS
Biologic-naïve PSO patients initiating etanercept or adalimumab therapy between 18 January 2008 and 31 December 2008 were identified. Patients continuously enrolled in the health plan for 6 months before and ≥12 months after therapy initiation were followed until disenrollment from the plan or 31 December 2009. Persistence was defined as continuous use of index TNF blocker without a gap in therapy ≥60 days. Patients with gaps in index therapy ≥60 days were classified as discontinuing, switching, or restarting the index therapy.


RESULTS
In total, 497 patients initiated etanercept and 330 the adalimumab therapy. Mean age for both groups was 43 years. Approximately 40-42% of patients were persistent on their index TNF blocker for 1 year. Among patients with a ≥60-day gap in therapy, discontinuation without restart or switch occurred in 37% of etanercept and 45% of adalimumab patients (p = 0.04). Differences in therapy restart or switching between the groups were not statistically significant.


CONCLUSIONS
TNF-blocker therapy persistence is low among PSO patients in this health plan. More than one-third of patients restarted their index TNF blocker after a gap in therapy.
OptumInsight, Eden Prairie, MN, USA. benjamin.chastek@optum.com
Benjamin
B
Chastek
Kathleen M
KM
Fox
Crystal
C
Watson
Gregory
G
Kricorian
Shravanthi R
SR
Gandra
D000068879:Adalimumab; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy*; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012189:Retrospective Studies; D013221:State Health Plans; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014481:United States
D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab; D000068800:Etanercept