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Background and Importance Psoriasis is a chronic inflammatory skin disease with a significant genetic predisposition and autoimmune mechanism. Medication adherence is crucial for effective disease management, leading to improved outcomes and quality of life. However, adherence to psoriasis treatments is often inadequate, resulting in adverse health outcomes and increased costs. Aim and Objectives Study aim was to assess medication adherence to psoriasis treatments in a real-world setting. Material and Methods Incident subjects received at least one prescription of biologic drug therapy for psoriasis (including apremilast) and/or with a psoriasis diagnosis were identified from a specific Database in 2017–2019 and followed for 1-year from the index-date. The three phases of the adherence process were assessed as per EMERGE guidelines: Initiation, expressed in terms of number of treatment plans prescribed/dispensed; Implementation, in terms of switch and swap rates; Discontinuation, in terms of drug interruption within 6- and 12-months, stratified by biologic drug therapy. Results Study cohort included 811 subjects aged 49.2±16.3 years, 60% male. Among males, secukinumab was the most commonly prescribed (66.7%); whilst among females, apremilast was the most prescribed (44.8%). Overall, 36.2% of cohort was in excessive polypharmacy. Suboptimal levels of adherence were detected: 7% of patients did not start the prescribed drug therapy (initiation phase); swap levels were about 13.1% with an average time to swap at 1-month (29±84.8 days) (implementation phase); overall, 51.5% of subjects interrupted biologic drug therapy within 87.5±127.7 days (figure 1). Persistence (third phase) varied depending on the individual drugs; patients treated with anti-IL17/23 recorded higher adherence levels (60.1%). Highest adherence rates were observed for patients on secukinumab (60.1%) and adalimumab (50.0%) treatment. In contrast, the highest discontinuation rates were found for patients treated with ustekinumab (67.7%) within three and a half months of starting therapy and Apremilast (52.7%) within about two months. Conclusion and Relevance This study highlights low levels of medication adherence in individuals undergoing psoriasis treatment, with significant discontinuation rates within the first three months. Higher adherence was observed among patients treated with anti-IL17 and anti-IL23 therapies. Further research is needed to identify predictors of medication non-adherence, particularly during the discontinuation phase, to enhance the management of psoriasis treatment. References and/or Acknowledgements Conflict of Interest No conflict of interest.
Serino et al. (Fri,) studied this question.