Patient reported health outcomes and non-adherence in psoriasis patients receiving adalimumab or ustekinumab for moderate to severe plaque psoriasis.

OBJECTIVE

The objective of this study is to compare health outcomes of patients using biologic therapies ustekinumab (UST) or adalimumab (ADA) for moderate-to-severe plaque psoriasis (PsO) and assess biologics non-adherence.

METHODS

Two phases of web-based survey data were collected, assessing adult patients with PsO from a Diplomat® Specialty Pharmacy US claims database (Diplomat Specialty Pharmacy; Flint, MI). Measures included demographics, treatment and health characteristics/behaviors, treatment satisfaction, health-related quality of life (HRQoL), and productivity. Pooled and stratified (by biologics experience) bivariate and multivariable analyses were conducted.

RESULTS

UST (n = 262) versus ADA (n = 83) users more frequently had psoriasis cleared (40.5% versus 15.4%, respectively, with no visible signs), better HRQoL as per Dermatology Life Quality Index (DLQI) score = 0 (45.2% versus 19.2%), and higher current effectiveness satisfaction, all p < 0.05. Adjusting for covariates, UST versus ADA bio-naïve patients (n = 68) had better (53.4% lower) DLQI scores, lower percent body surface affected (%BSA; 0.85 versus 1.43), more %BSA improvement (-1.60 versus -1.03), and lower activity impairment (90.4% lower), all p < 0.05. Non-adherence to UST (11.8%) versus ADA (32.5%) was lower, p < 0.05, and more access versus forgetfulness-related. However, no significant differences emerged on outcomes between overall or bio-experienced UST and ADA users.

CONCLUSIONS

UST versus ADA PsO bio-naïve patients reported higher clearing rates, better DLQI, and lower activity impairment.