Real-world dose escalation of biologics for moderate-to-severe psoriasis in the United States

• Published in: The Journal of dermatological treatment Vol. 34; no. 1; p. 2200869
• Main Authors: Wu, Jashin J., Patel, Manish, Zeng, Feng, Huang, Ahong, Pan, Xing, Cao, Yiwen, Chen, Naijun, Photowala, Huzefa, Garg, Vishvas, Crowley, Jeff
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 31.12.2023; Taylor & Francis Group
• Subjects: Adalimumab - therapeutic use; Adult; Biological Products - therapeutic use; dose escalation; Humans; Interleukin Inhibitors; Interleukin-23; Psoriasis; Psoriasis - drug therapy; Psoriasis - pathology; real-world data; Tumor Necrosis Factor-alpha; United States; Ustekinumab - therapeutic use; United States; Psoriasis; dose escalation; real-world data
• ISSN: 0954-6634; 1471-1753
• DOI: 10.1080/09546634.2023.2200869

To compare real-world dose escalation of risankizumab with other US Food and Drug Administration (FDA)-approved biologic treatments for management of moderate-to-severe psoriasis (PsO) in the United States. The Merative® MarketScan® Research Database was used to identify adults with ≥2 medical claims for PsO, ≥3 claims of the index biologic medication in the maintenance period, and ≥6 months continuous enrollment pre-induction and ≥6 months after initiation of the maintenance period. Dose escalation was defined as ≥2 dosing intervals where the average daily dose was ≥30% higher than the expected daily dose (per FDA-approved dosing). Comparisons between risankizumab and other cohorts were made using chi-square tests and logistic regression models. At the 30% threshold, the percentage of patients with dose escalation in the full maintenance period was significantly lower with risankizumab (2.0%) compared with other drug classes (tumor necrosis factor, interleukin (IL)-12/23, IL-17, or other IL-23 inhibitors: 17.6%, 10.0%, 18.3%, or 7.1%, respectively; p < 0.0001 for each) and individual biologics (adalimumab, ustekinumab, secukinumab, ixekizumab, and guselkumab; 17.9%, 10.0%, 15.7%, 18.0%, and 7.2%, respectively; p < 0.0001). A significantly lower proportion of risankizumab-treated patients with PsO had dose escalations compared with patients treated with other biologics.