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Journal of the American Academy of Dermatology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le mardi 28 janvier 2020
Doi : 10.1016/j.jaad.2019.11.015
accepted : 5 November 2019
Comparison of real-world treatment patterns among patients with psoriasis prescribed ixekizumab or secukinumab

Andrew Blauvelt, MD, MBA a, Nianwen Shi, PhD b, Russel Burge, PhD c, d, William N. Malatestinic, PharmD, MBA c, Chen-Yen Lin, PhD c, Carolyn R. Lew, PhD b, Nicole M. Zimmerman, MS b, Orin M. Goldblum, MD c, Baojin Zhu, PhD c, Mwangi J. Murage, PhD, MPH c,
a Oregon Medical Research Center, Portland, Oregon 
b IBM Watson Health, Cambridge, Massachusetts 
c Eli Lilly and Company, Indianapolis, Indiana 
d University of Cincinnati, Division of Pharmaceutical Sciences, Winkle College of Pharmacy, Cincinnati, Ohio 

Reprint requests: Mwangi J. Murage, PhD, MPH, Global Patient Outcomes and Real World Evidence (GPORWE), Eli Lilly and Company, USA, LCT-South Bldg 171-2, Drop Code 5221, 1555 Harding St, Indianapolis, IN 46221.Global Patient Outcomes and Real World Evidence (GPORWE)Eli Lilly and Company, USALCT-South Bldg 171-2, Drop Code 5221, 1555 Harding StIndianapolisIN46221

Real-world data on treatment patterns associated with use of interleukin-17A inhibitors in psoriasis are lacking.


To compare treatment patterns between ixekizumab or secukinumab users in clinical practice.


A retrospective cohort study included patients with psoriasis aged ≥18 years treated with ixekizumab or secukinumab between March 1, 2016, and May 31, 2018 in IBM MarketScan (IBM Corp, Armonk, NY) databases. Inverse probability of treatment weighting and multivariable models were used to address cohort imbalances and estimate the risks of nonpersistence (60-day gap), discontinuation (≥90-day gap), switching, and the odds of adherence.


The study monitored 645 ixekizumab users for 13.7 months and 1152 secukinumab users for 16.3 months. Ixekizumab users showed higher persistence rate (54.8% vs 45.1%, P  < .001) and lower discontinuation rate (37.8% vs 47.5%, P  < .001) than secukinumab. After multivariable adjustment, ixekizumab users had lower risks of nonpersistence (hazard ratio, 0.82; 95% confidence interval, 0.71-0.95) and discontinuation (hazard ratio, 0.82; 95% confidence interval, 0.70-0.96), and higher odds of high adherence to treatment measured by a medication possession ratio ≥80% (hazard ratio, 1.31; 95% confidence interval, 1.07-1.60). The risk of switching was similar between cohorts.


Disease severity and clinical outcomes were unavailable.


Ixekizumab users demonstrated longer drug persistence, lower discontinuation rate and risk of discontinuation, higher likelihood of adherence, and similar risk of switching compared with secukinumab users in clinical practices.

The full text of this article is available in PDF format.

Key words : ixekizumab, psoriasis, secukinumab, treatment adherence, treatment discontinuation, treatment persistence, treatment switching

Abbreviations used : CI, HR, ICD-9/10-CM, IPTW, IXE, MPR, PDC, SEC

 Funding sources: Eli Lilly and Company.
 Conflicts of interest: Dr Blauvelt had received honoraria as a scientific adviser/clinical study investigator from AbbVie, Aclaris, Akros, Allergan, Almirall, Amgen, Arena, Athenex, Boehringer Ingelheim, Celgene, Dermavant, Dermira, Inc, Eli Lilly and Company, Galderma, Genentech/Roche, GlaxoSmithKline, Janssen, LEO, Meiji, Merck Sharp & Dohme, Novartis, Pfizer, Purdue Pharma, Regeneron, Revance, Sandoz, Sanofi Genzyme, Sienna Pharmaceuticals, Sun Pharma, UCB Pharma, Valeant, and Vidac, and as a paid speaker from AbbVie, Regeneron, and Sanofi Genzyme, but none related to this work. Dr Shi, Dr Lew, and Nicole M. Zimmerman are employees of IBM Watson Health that was compensated by Eli Lilly and Company for conducting this research. Drs Burge, Malatestinic, Lin, Goldblum, Zhu, and Murage are employees of Eli Lilly and Company and hold stock in Eli Lilly and Company.
 Portions of this study were presented as a poster at the 2019 Annual Meeting of the American Academy of Dermatology, Washington, DC, March 1-5, 2019.
 IRB approval status: Not applicable. All study data were accessed with protocols compliant with United States patient confidentiality requirements, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations. Because all databases used in the study are fully deidentified and compliant with the HIPPA, this study was exempted from Institutional Review Board approval.

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