Study: Pediatric Usage, Drug Survival of Systemic, Phototherapy Treatments

A recent study examines systemic and phototherapy treatment utilization and drug survival in pediatric patients with psoriasis.

Recently, a study published in Pediatric Dermatology examined systemic and phototherapy treatment utilization, along with a comparison of drug survival among systemics in pediatric psoriasis. 

The authors pointed out that while systemic medications and phototherapy are used to treat pediatric psoriasis, real-world data on its utilizations and persistence are limited. 

A cross-sectional analysis was conducted using United States commercial insurance claims data to describe the prevalence of therapy usage among patients younger than 18 years. Using a retrospective cohort design, they compared drug survival of methotrexate, adalimumab (Humira; AbbVie), etanercept (Enbrel; Amgen), and ustekinumab (Stelara; Janssen Pharmaceuticals) in new users. 

Results of the analysis showed that in 13,759 patients, 14.6% used systemic or phototherapy during 2001 to 2016. Over that time, there was rising utilization of systemics. Among 579 new users of methotrexate, adalimumab, etanercept, and ustekinumab, median duration of initial treatment was 141 (IQR 59-314), 179 (79-339), 175 (90-419), and 216 (64-435) days, respectively (P = .04).

Ustekinumab (HR 0.47 [95% CI 0.27-0.83]), etanercept (0.74 [0.59-0.92]), and adalimumab (0.75 [0.55-1.02]) were less likely to be discontinued compared to methotrexate initiators. This data was found after adjustments were made for sociodemographic factors and psoriatic arthritis. Drug survival differences were also limited to systemic-naïve patients.

The authors noted that a short follow-up and residual confounding could be potential limitations to the study. However, they concluded that utilization of systemic therapies for patients under the age of 18 is increasing, but difference in drug survival exists.

Reference:

1. Wan J, Shin DB, Gelfand JM. Treatment utilization and drug survival of systemic medications among commercially insured children with psoriasis. Pediatr Dermatol. Published online August 31, 2021:pde.14781. doi: 10.1111/pde.14781.