Open AccessBiologic initiation rates in systemic-naive psoriasis patients after first-line apremilast versus methotrexate use
Author(s) -
David L. Kaplan,
Elaine Husni,
Eunice Chang,
Michael S. Broder,
Caleb Paydar,
Katalin Bognar,
Jessie T. Yan,
Sven Richter,
Pooja Desai,
Ibrahim Khilfeh
Publication year - 2022
Publication title -
journal of comparative effectiveness research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.567
H-Index - 23
eISSN - 2042-6313
pISSN - 2042-6305
DOI - 10.2217/cer-2021-0311
Subject(s) - medicine , apremilast , methotrexate , hazard ratio , psoriasis , odds ratio , retrospective cohort study , gastroenterology , confidence interval , psoriatic arthritis , immunology
Aim: To compare rates of biologic initiation after commencing treatment with apremilast (APR) versus methotrexate (MTX) in systemic-naive patients with psoriasis (PsO). Methods: This was a retrospective cohort study of systemic-naive patients with PsO who initiated treatment with APR or MTX between 1 January 2015 and 31 March 2018. Outcomes: Adjusted rates of biologic initiation during follow-up were compared by logistic and Cox regressions. Results: APR initiators had 58% lower likelihood of biologic initiation (odds ratio: 0.42; 95% CI: 0.37-0.48; p < 0.001), lower adjusted biologic initiation rate (14.4% [95% CI: 13.2-15.7%] vs 28.6% [95% CI: 26.8-30.5%]), lower risk of biologic initiation (hazard ratio: 0.45; 95% CI: 0.40-0.51; p < 0.001) compared with MTX initiators. Conclusion: Systemic-naive patients with PsO have a lower rate of biologic initiation over 1 year following APR initiation.