Treatment Persistence of Interleukin-17 Inhibitors and Factors Associated with Persistence in Patients with Psoriasis...

Psoriasis vulgaris (PsV) is a chronic, immune-mediated skin disorder that significantly impairs quality of life and often necessitates long-term systemic therapy, especially in moderate-to-severe cases. In Japan, biologic agents targeting interleukin-17 (IL-17) have become central to the management of PsV; however, real-world evidence on their long-term persistence and associated factors remains limited.

This retrospective study utilized the Medical Data Vision database to evaluate treatment persistence of IL-17 inhibitors (ixekizumab, secukinumab, brodalumab, or bimekizumab) and factors associated with treatment persistence in Japanese patients with PsV. Patients aged ≥ 15 years with a confirmed diagnosis of PsV and at least one claim of an IL-17 inhibitor between February 2015 and October 2023 were included. Persistence rates of IL-17 inhibitors (including ixekizumab) and ixekizumab were analyzed using the Kaplan-Meier method. Cox proportional hazard regression models were also used to calculate hazard ratios for factors associated with the treatment persistence of IL-17 inhibitors and ixekizumab.

The persistence rates at 48 months among patients treated with IL-17 inhibitors (n = 2904) and ixekizumab (n = 1105) were 52.4% and 41.2%, respectively. Similar rates were observed for ixekizumab dosing Q2/Q2 (46.9%) and Q2/Q4 (48.1%). Gender was a factor influencing treatment persistence in the IL-17 inhibitor cohort; however, no such association was observed in the ixekizumab cohort. Prior biologic experience was associated with shorter persistence for both IL-17 inhibitors and ixekizumab. No other demographic or clinical factors showed a significant association. Following ixekizumab treatment, use of phototherapy, topical, and systemic therapies declined, suggesting a shift toward biologic monotherapy.

These findings provide real-world evidence of the sustained use of IL-17 inhibitors in Japanese patients with PsV. Persistence showed no significant association with patient characteristics such as age, comorbidities, and concomitant medications.