P74 AMGEVITA® persistence in patients with plaque psoriasis: a retrospective database analysis from the British Association of Dermatologists Biologics and Immunomodulators Register
Authors: Shams Kave , Morley Jason , Gerasimaviciute Vaiva , Seesaghur Anouchka , Duxbury Michael , Neasham David , Baxter Richard , Montgomery Jennifer , Taylor Andrew 
Published: June 2023

Abstract
While multiple studies have evaluated the persistence of biologic agents in patients with plaque psoriasis (Yiu ZZN, Becher G, Kirby B et al. Drug survival associated with effectiveness and safety of treatment with guselkumab, ixekizumab, secukinumab, ustekinumab and adalimumab in patients with psoriasis. JAMA Dermatol 2022; 158:1131–41), persistence data for adalimumab biosimilars are limited. From BADBIR, we assessed AMGEVITA persistence in UK patients aged ≥ 18 years with a diagnosis of chronic plaque psoriasis, who had received at least one dose of AMGEVITA between October 2018 and July 2021 with at least 6 months of follow-up. Study outcomes included AMGEVITA persistence at 6, 12, 18 and 24 months (primary); reasons for AMGEVITA discontinuation (secondary) and Psoriasis Area Severity Index (PASI) score from baseline to 6 months after AMGEVITA start date (exploratory). Outcomes were analysed overall and separately for biologic-experienced (transitioned to AMGEVITA from another biologic) vs. biologic-naïve (started AMGEVITA with no prior biologics) patients. Persistence was defined as the continuous use of AMGEVITA from first administration to discontinuation using a permissible gap of &lt; 90 days assessed using Kaplan–Meier survival methodology. Of 1432 eligible patients, most (n = 1,183; 82.6%) were biologic experienced, 40.1% (n = 574) were female and 56% were aged 35–54 years. At AMGEVITA initiation, mean (SD) time since psoriasis diagnosis overall was 25.4 (12.9) years, and 20.6 (12.6) and 26.6 (12.7) years in biologic-naïve and biologic-experienced patients, respectively; mean (SD) PASI was 8.1 (8.7) in the overall population, and 14.8 (7.6) and 3.2 (5.6) in biologic-naïve and biologic-experienced patients, respectively. Overall, AMGEVITA persistence at 6, 12, 18 and 24 months was 0.94 [95% confidence interval (CI) 0.93–0.95], 0.87 (95% CI 0.86–0.89), 0.84 (95% CI 0.82–0.86) and 0.82 (95% CI 0.80–0.84), respectively; 17.7% (n = 253) of patients discontinued AMGEVITA and mean (SD) time to discontinuation was 9.4 (6.0) months. The most common reasons for AMGEVITA discontinuation were ineffectiveness (n = 102; 40.3%) and adverse events (n = 74; 29.2%). Persistence at 6, 12, 18 and 24 months was higher in biologic-experienced patients than in biologic-naïve patients: 0.94 (95% CI 0.92–0.95), 0.88 (95% CI 0.86–0.90), 0.85 (95% CI 0.83–0.87) and 0.84 (95% CI 0.81–0.86) vs. 0.94 (95% CI 0.91–0.97), 0.84 (95% CI 0.78–0.88), 0.77 (95% CI 0.71–0.82) and 0.74 (95% CI 0.68–0.80), respectively. Mean (SD) time to AMGEVITA discontinuation was similar in biologic-naïve and biologic-experienced patients: 9.0 (6.1) and 10.5 (5.6) months, respectively. Among patients with non-missing data (n = 94 in both groups), mean (SD) change in PASI score at 6 months was −11.3 (8.6) in biologic-naïve and −1.0 (4.4) in biologic-experienced patients. In conclusion, patients with chronic plaque psoriasis initiating AMGEVITA in UK clinical practice demonstrated high drug persistence over 2 years, irrespective of prior biologic use.
Funding sources: this analysis was funded by Amgen.