PSY29 - REAL-WORLD DISCONTINUATION OF BIOLOGICAL TREATMENTS IN MODERATE-TO-SEVERE PLAQUE PSORIASIS OVER THE FIRST 5 YEARS OF TREATMENT – A LITERATURE REVIEW OF DRUG SURVIVAL

Abstract

During the past decade, drug survival has become a real-life measurement for the success of treatments for plaque psoriasis. The objective of this study was to synthesize and quantify published evidence on real-world drug discontinuation for biological treatments used in moderate-to-severe plaque psoriasis over the first 5 years of treatment. A literature review was conducted in May 2018. The search was limited to the last 5 years. Case review studies with small study samples and single-center cohort studies (< 300 patients) were excluded. Drug survival rates at specific timepoints were extracted or calculated from the included studies and weighted according to the sample size of each study. For each timepoint, a weighted average drug survival rate was calculated, which was then transformed into 4-week discontinuation rates. The identified studies reported drug survival rates for adalimumab (ADA), etanercept (ETA), infliximab (INF), ustekinumab (UST), and secukinumab (SEC). ETA and SEC had the longest and shortest follow-up time of 10 and 1.5 years, respectively. In the first year, 4-week discontinuation rates were 2.6%, 2.4%, 2.4%, 2.2%, and 1.2% for ETA, INF, ADA, SEC, and UST, respectively. For each year, a declining trend in discontinuation rates was seen for ETA, ADA, and UST (range: 0.5-0.7% at year 5). Similarly, a declining trend was observed for INF except for year 5. The discontinuation rates for SEC at year 1 and 1.5 were high at comparable levels (2.3% vs. 2.2%). This study indicates a declining trend in discontinuation rates for ETA, ADA, and UST over time, and for INF for all years except the last. Discontinuation rates for SEC are still uncertain due to the lack of evidence, however, the findings indicate early signs of high discontinuation for SEC. Further high quality observational studies are needed to confirm this.