Real-world switching and discontinuation patterns for biologic disease-modifying antirheumatic drugs in patients with active psoriatic arthritis in Japan

ObjectivesTo evaluate switching and discontinuation of biologic disease-modifying antirheumatic drugs (bDMARDs) among psoriatic arthritis (PsA) patients in Japan over 12 months. MethodsClaims data from the Japan Medical Data Centre (1/2005-10/2023) were analysed for patients with a PsA diagnosis on or before first bDMARD claim (index date) and ≥ 6 months of eligibility pre-index. Treatment switch (claim for another bDMARD) and discontinuation (treatment gap ≥150% days' supply of last prescription) were evaluated up to 12 months post-index. Hazard ratios for switching and discontinuation were estimated using multivariate Cox proportional hazards models adjusted for baseline characteristics. ResultsIncluded patients received adalimumab (n = 323), brodalumab (n = 71), certolizumab pegol (n = 162), guselkumab (n = 157), ixekizumab (n = 239), risankizumab (n = 117), secukinumab (n = 250), or ustekinumab (n = 60). At 12 months, 21.7% switched bDMARDs and 38.1% discontinued their index bDMARD. Risankizumab had the lowest switching rate (18.4%), followed by secukinumab (19.1%) and ixekizumab (19.7%). Risankizumab had the lowest discontinuation rate (23.4%), followed by ustekinumab (27.6%) and ixekizumab (29.7%). Hazard ratios of switching and/or discontinuation were significantly higher for most bDMARDs (except ixekizumab, ustekinumab) versus risankizumab (P < .05). ConclusionSwitching and discontinuation were common within 1-year of bDMARD treatment for PsA patients in Japan. Risankizumab demonstrated the lowest rates of switching and/or discontinuation.