We use cookies to improve your experience. By continuing to browse this site, you accept our cookie policy.×
Skip main navigation
Aging Health
Bioelectronics in Medicine
Biomarkers in Medicine
Breast Cancer Management
CNS Oncology
Colorectal Cancer
Concussion
Epigenomics
Future Cardiology
Future Medicine AI
Future Microbiology
Future Neurology
Future Oncology
Future Rare Diseases
Future Virology
Hepatic Oncology
HIV Therapy
Immunotherapy
International Journal of Endocrine Oncology
International Journal of Hematologic Oncology
Journal of 3D Printing in Medicine
Lung Cancer Management
Melanoma Management
Nanomedicine
Neurodegenerative Disease Management
Pain Management
Pediatric Health
Personalized Medicine
Pharmacogenomics
Regenerative Medicine
Short Communication

Adherence, persistence and treatment switching in psoriasis

    ,
    Felice Musicco

    San Gallicano Dermatological Institute - IRCCS, Rome Italy

    ,
    Chiara Fulgenzio

    San Gallicano Dermatological Institute - IRCCS, Rome Italy

    ,
    Paolo Abrate

    Hospital Pharmacy of Ivrea, Ivrea, Italy

    ,
    Laura Pestrin

    Hospital Pharmacy of Ivrea, Ivrea, Italy

    ,
    Enrico Pasut

    Service of Pharmacy, Azienda Sanitaria Universitaria del Friuli Centrale (ASUFC), Udine, Italy

    ,
    Germana Modesti

    Service of Pharmacy, Azienda Sanitaria Universitaria del Friuli Centrale (ASUFC), Udine, Italy

    ,
    Romina Giannini

    Pharmacy Department ASL BAT, Bari-Andria-Trani, Italy

    ,
    Stefania De Rosa

    Pharmacy Department ASL BAT, Bari-Andria-Trani, Italy

    ,
    Mariantonietta Piccoli

    Brindisi General Hospital, Brindisi, Italy

    ,
    Grazia Mingolla

    Brindisi General Hospital, Brindisi, Italy

    ,
    Eva Zuzolo

    San Gallicano Dermatological Institute - IRCCS, Rome Italy

    ,
    Pietro Gazzola

    IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy

    ,
    Martina Roperti

    IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy

    ,
    Gabriella Pieri

    IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy

    ,
    Valentina Montresor

    “Ospedale P. Pederzoli” Casa di Cura Privata S.p.A.Via Monte Baldo

    ,
    Isabella Martignoni

    “Ospedale P. Pederzoli” Casa di Cura Privata S.p.A.Via Monte Baldo

    ,
    Marco Gambera

    “Ospedale P. Pederzoli” Casa di Cura Privata S.p.A.Via Monte Baldo

    ,
    Roberto Langella

    Pharmacy Department, Agency for Health Protection (ATS) of Milan,Italy

    ,
    Gabriella Tinari

    Ortona General Hospital, Contrada S. Liberata, Ortona, Italy

    ,
    Concetta Spoltore

    Lanciano General Hospital, Via del mare, Lanciano, Italy

    ,
    Cristina Roberti

    Vasto General Hospital, Via San Camillo de Lellis, Vasto, Italy

    ,
    Letizia Di Fabio

    Vasto General Hospital, Via San Camillo de Lellis, Vasto, Italy

    ,
    Laura Grossi

    Chieti General Hospital, Via dei Vestini, Chieti Italy

    ,
    Francesca Guarino

    Chieti General Hospital, Via dei Vestini, Chieti Italy

    ,
    Francesco De Vita

    Lanciano General Hospital, Via del mare, Lanciano, Italy

    ,
    Ruggero Lasala

    Hospital Pharmacy of Corato, Local Health Unit of Bari, Bari, Italy

    &
    Published Online:https://doi.org/10.2217/imt-2023-0343

    Aim: This study aims to investigate drug utilization patterns in the treatment of psoriasis (PsO) from 1 to 5 years in a real-life setting with Adalimumab (Ada), Etanercept (Eta), Ustekinumab (Ust), Golimumab (Gol), Ixekizumab (Ixe), Secukinumab (Sec) and Apremilast (Apr). Materials & methods: Data from an observational study were used to calculate adherence using the Proportion of Days Covered (PDC) method and persistence. Results & conclusion: Treatment adherence was found to be good for all the drugs studied across all years of analysis, while persistence was suboptimal, showing a marked decrease from the third year of study onward. In the treatment of PsO, greater attention needs to be paid to treatment persistence.

    Plain language summary

    This summary explains that when a patient follows their doctor's medication instructions and continues using the same medication over time to treat a condition like psoriasis, they can expect safer and more effective outcomes. This study examined these aspects to assess how different medications perform over the long term and to explore ways to improve their prescription. The findings highlight that the main issue is not so much in following instructions but in continuing to use the same medication throughout the treatment duration. Raising awareness among healthcare professionals about these issues is crucial to help patients maintain consistent therapy over time and improve their care pathway.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

    References

    • 1. Samarasekera EJ, Neilson JM, Warren RB et al. Incidence of cardiovascular disease in individuals with psoriasis: a systematic review and meta-analysis. J Invest Dermatol. 2013;133(10):2340–2346. doi:10.1038/jid.2013.149
    • 2. Boehncke WH, Boehncke S. More than skin-deep: the many dimensions of the psoriatic disease. Swiss Med Wkly 2014;144:w13968. doi:10.4414/smw.2014.13968
    • 3. Dowlatshahi EA, Wakkee M, Arends LR et al. The prevalence and odds of depressive symptoms and clinical depression in psoriasis patients: a systematic review and meta-analysis. J Invest Dermatol. 2014;134(6):1542–1551. doi:10.1038/jid.2013.508
    • 4. Kolios AG, Yawalkar N, Anliker M et al. Swiss S1 guidelines on the systemic treatment of psoriasis vulgaris. Dermatology 2016;232(4):385–406. doi:10.1159/000445681
    • 5. American Academy of Dermatology Work G, Menter A, Korman NJ et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 6. Guidelines of care for the treatment of psoriasis and psoriatic arthritis: case-based presentations and evidence-based conclusions. J Am Acad Dermatol. 2011;65(1):137–174. doi:10.1016/j.jaad.2010.11.055
    • 6. Leonardi CL, Romiti R, Tebbey PW. Ten years on: the impact of biologics on the practice of dermatology. Dermatol Clin. 2015;33(1):111–125. doi:10.1016/j.det.2014.09.009
    • 7. Langley RG, Elewski BE, Lebwohl M et al. Secukinumab in plaque psoriasis–results of two Phase III trials. New England J Med. 2014;371(4):326–338. doi:10.1056/NEJMoa1314258
    • 8. Armstrong A, Fahrbach K, Leonardi C et al. Efficacy of bimekizumab and other biologics in moderate-to-severe plaque psoriasis: a systematic literature review and a network meta-analysis. Dermatol Ther. (Heidelb) 2022;12(8):1777–1792. doi:10.1007/s13555-022-00760-8
    • 9. Papp K, Reich K, Leonardi CL et al. Apremilast, an oral phosphodiesterase 4 (PDE4) inhibitor, in patients with moderate-to-severe plaque psoriasis: results of a phase III, randomized, controlled trial (Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis [ESTEEM] 1). J Am Acad Dermatol. 2015;73(1):37–49. doi:10.1016/j.jaad.2015.03.049
    • 10. Schwartz DM, Kanno Y, Villarino A et al. JAK inhibition as a therapeutic strategy for immune and inflammatory diseases. Nat Rev Drug Discov. 2017;16(12):843–862. doi:10.1038/nrd.2017.201
    • 11. Menter A, Gelfand JM, Connor C et al. Joint American Academy of Dermatology-National Psoriasis Foundation guidelines of care for the management of psoriasis with systemic nonbiologic therapies. J Am Acad Dermatol. 2020;82(6):1445–1486. doi:10.1016/j.jaad.2020.02.044
    • 12. Augustin M, Kleyn CE, Conrad C et al. Characteristics and outcomes of patients treated with apremilast in the real world: results from the APPRECIATE study. J Eur Acad Dermatol Venereol. 2021;35(1):123–134. doi:10.1111/jdv.16431
    • 13. Ozkok Akbulut T, Topaloglu Demir F, Oguz Topal I et al. Drug survival and predictor factors for discontinuation of methotrexate in psoriasis: a real-life multicenter study. Int J Dermatol. 2021;60(9):1140–1147. doi:10.1111/ijd.15628
    • 14. Ismail N, Collins P, Rogers S et al. Drug survival of fumaric acid esters for psoriasis: a retrospective study. British J Dermatol. 2014;171(2):397–402. doi:10.1111/bjd.12849
    • 15. Levin AA, Gottlieb AB, Au SC. A comparison of psoriasis drug failure rates and reasons for discontinuation in biologics vs conventional systemic therapies. J Drugs Dermatol. 2014;13(7):848–853.
    • 16. Cramer JA, Roy A, Burrell A et al. Medication compliance and persistence: terminology and definitions. Value in Health 2008;11(1):44–47. doi:10.1111/j.1524-4733.2007.00213.x
    • 17. Gniadecki R, Kragballe K, Dam TN et al. Comparison of drug survival rates for adalimumab, etanercept and infliximab in patients with psoriasis vulgaris. British J Dermatol. 2011;164(5):1091–1096. doi:10.1111/j.1365-2133.2011.10213.x •• Persistence as an indicator of the effectiveness of therapies in psoriasis, the basis for the analysis conducted in this study.
    • 18. Anghel LA, Farcas AM, Oprean RN. An overview of the common methods used to measure treatment adherence. Med Pharm Rep. 2019;92(2):117–122. doi:10.15386/mpr-1201 • Explanation of the method for calculating treatment adherence, essential for interpreting the results obtained in this study.
    • 19. Vrijens B, De Geest S, Hughes DA et al. A new taxonomy for describing and defining adherence to medications. Br J Clin Pharmacol. 2012;73(5):691–705. doi:10.1111/j.1365-2125.2012.04167.
    • 20. Leonardi C, Zhu B, Malatestinic WN et al. Real-world biologic adherence, persistence, and monotherapy comparisons in US patients with psoriasis: results from IBM MarketScan((R)) databases. Advan Ther. 2022;39(7):3214–3224. doi:10.1007/s12325-022-02155-9
    • 21. Belinchon I, Rivera R, Blanch C et al. Adherence, satisfaction and preferences for treatment in patients with psoriasis in the European Union: a systematic review of the literature. Patient Prefer Adher. 2016;10:2357–2367. doi:10.2147/PPA.S117006
    • 22. Doshi JA, Takeshita J, Pinto L et al. Biologic therapy adherence, discontinuation, switching, and restarting among patients with psoriasis in the US Medicare population. J Am Acad Dermatol. 2016;74(6):1057–65 e4. doi:10.1016/j.jaad.2016.01.048
    • 23. Huang YH, Tang CH, Goh CH et al. Persistence and adherence to biologics in patients with psoriasis in Taiwan: a new biologics user cohort study. Front Pharmacol. 2022;13:880985. doi:10.3389/fphar.2022.880985
    • 24. Piragine E, Petri D, Martelli A et al. Adherence and persistence to biological drugs for psoriasis: systematic review with meta-analysis. J Clin Med. 2022;11(6):1506 doi:10.3390/jcm11061506 • A recent and in-depth review of adherence levels in psoriasis, a useful tool for comparing the data analyzed in this study.
    • 25. 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(10):1131–1141. doi:10.1001/jamadermatol.2022.2909
    • 26. Costanzo A, Malara G, Pelucchi C et al. Effectiveness end points in real-world studies on biological therapies in psoriasis: systematic review with focus on drug survival. Dermatology 2018;234(1–2):1–12. doi:10.1159/000488586
    • 27. Torres T, Puig L, Vender R et al. Drug Survival of IL-12/23, IL-17 and IL-23 inhibitors for psoriasis treatment: a retrospective multi-country, multicentric cohort study. Am J Clin Dermatol. 2021;22(4):567–579. doi:10.1007/s40257-021-00598-4 •• An interesting study that highlights how over time there is a proportional loss of persistence that deserves attention, especially in long-term treatments such as those prescribed for the treatment of psoriasis.
    • 28. Lin PT, Wang SH, Chi CC. Drug survival of biologics in treating psoriasis: a meta-analysis of real-world evidence. Sci Rep. 2018;8(1):16068. doi:10.1038/s41598-018-34293-y •• A meta-analysis over a 4-year period, a useful comparison for this study with data on the medium to long term.