Ixekizumab bests adalimumab in adherence, persistence in psoriasis

Patients with psoriasis who were treated with ixekizumab were more likely to adhere to therapy compared with those treated with adalimumab over a 24-month period, according to a study.

“There is a paucity of long-term real-world evidence comparing the effectiveness of ixekizumab and adalimumab,” Andrew Blauvelt, MD, MBA, a dermatologist and president of Oregon Medical Research Center in Portland, Oregon, and colleagues wrote.

In the retrospective observational study, the researchers compared real-world patterns for the treatment of psoriasis using the two drugs over a 24-month span in the U.S.

Data were culled from the IBM Watson Health MarketScan Databases.

Eligible participants were adults with psoriasis who had one claim for ixekizumab or adalimumab between March 1, 2016, and Oct. 31, 2019. The researchers assessed patient data to estimate risks for non-persistence, discontinuation and switching of therapies. Findings associated with reinitiation and dosing also underwent analysis.

Ultimately, 475 patients treated with ixekizumab and 3,159 treated with adalimumab were included.

Adherence rates were 36.3% for ixekizumab users compared with 28.8% for adalimumab users (P < .001). Ixekizumab also bested adalimumab in terms of persistence (35.2% vs. 28.8%; P = .004). Discontinuation rates were 59.1% for ixekizumab and 65.3% for adalimumab (P = .007).

Multivariable analysis showed that ixekizumab was associated with a higher likelihood of treatment adherence than adalimumab (OR = 1.52; 95% CI, 1.24-1.87). In addition, ixekizumab carried lower risks of both non-persistence (HR = 0.84; 95% CI, 0.75-0.95) and discontinuation (HR = 0.83; 95% CI, 0.74-0.94).

The researchers noted that switching rates were 31.2% for ixekizumab and 30% for adalimumab, which they described as “similar.”

“The results of this study supplement the data derived from randomized controlled trials for [ixekizumab] and [adalimumab] to provide important information on their effectiveness in routine clinical practice and will help to inform decisions by both health care providers and payers in their treatment selection for patients with moderate to severe psoriasis,” the researchers concluded.