Characteristics of Patients Initiating Guselkumab for Plaque Psoriasis in the Symphony Health Claims Database
October 2021 | Volume 20 | Issue 10 | Features | 1127 | Copyright © October 2021
Published online September 28, 2021
Timothy Fitzgerald PhD MAa, Amanda Teeple MPHa, Terra Slaton MSb, Chris M. Kozma PhDb
aJanssen Scientific Affairs LLC, Horsham, PA
bCK Consulting Associates, LLC, Saint Helena Island, SC
Guselkumab is approved by the Food and Drug Administration for the treatment of moderate-to-severe plaque psoriasis. However, characteristics of patients initiating guselkumab in a real-world setting are not well characterized. The present study described baseline characteristics of patients with psoriasis initiating guselkumab in the first year after approval using data from the Symphony Health Claims database. Adult patients with psoriasis with ≥1 claim for guselkumab between 7/13/2017 and 7/2/2018 were included. The index date was defined as the date of the first pharmacy claim for guselkumab. Outcomes of interest included demographics, frequency of prior biologic and non-biologic psoriasis treatments, and frequency of diagnoses or procedures during the year before guselkumab initiation (baseline period). A total of 1,520 patients were included. Mean age was 51.2 (SD 13.4) years and 53.7% of patients were female. During the baseline period, 63.9% of patients had ≥1 biologic drug claim and 66.9% were prescribed topical corticosteroids/combinations. The most common non-psoriasis diagnoses among patients with ≥1 medical claim were hypertension (25.1%), type 2 diabetes (13.4%), and hyperlipidemia (13.4%). The most common procedures reflected routine medical care. These findings describing the baseline characteristics of patients initiating guselkumab provide insights regarding variables that may impact observed treatment outcomes and may ultimately help with treatment decision making. J Drugs Dermatol
. 2021;20(10):1127-1131. doi:10.36849/JDD.6024
Psoriasis is a chronic dermatologic disease that affects more than 7.4 million individuals in the United States (US).1 Biologic therapies targeting inflammatory cytokines have become an important treatment option for patients with moderate-to-severe psoriasis.2 Several biologics that inhibit interleukin 17 (IL-17) or IL-23 have recently been approved in this indication by the Food and Drug Administration (FDA), as these cytokines are integral to the pathogenesis of psoriasis.3,4 Guselkumab (CNTO 1959; Janssen Research & Development LLC, Spring House, PA), a novel human monoclonal antibody that inhibits IL-23, was the first biologic of its class approved by the FDA for the treatment of adult patients with moderate-to- severe plaque psoriasis.5,6
Describing the baseline characteristics of patients who are initiating a recently approved therapy is important to provide insights regarding variables that may impact observed treatment outcomes, which may ultimately play a role in treatment decision making. However, the characteristics of patients with psoriasis initiating treatment with guselkumab in a real-world setting are not well characterized. The objective of the present study was to describe the baseline characteristics and treatment history of patients with psoriasis who initiated guselkumab during the first year after FDA approval using real- world data from the Symphony Health Claims database.
MATERIALS AND METHODS
A retrospective, descriptive analysis was conducted using data from the Symphony Health Claims database. This database includes US pharmacy, diagnosis, and procedure claims collected through electronic claims processors, commercial sources, and government sources (Medicare and Medicaid). Over 93% of outpatient prescriptions dispensed in the US and territories are captured in this database.7 Furthermore, the Symphony database is built around claims processors and therefore approximates “real-time” data, allowing for evaluation relatively soon after product approval.
The present study included patients with psoriasis aged 18 years or greater who had ≥2 psoriasis diagnoses separated by at least 30 days between 10/01/2012 and 08/31/2018. Patients were included if they had ≥1 claim for guselkumab between 7/13/2017 (the FDA approval date for guselkumab in psoriasis) and 7/2/2018. The index date was defined as the date of the first pharmacy claim for guselkumab and the baseline period was defined as the 365-day period prior to the index date. Patients were excluded if they had claims for >1 biologic on the index date or if they had claims with potential day supply problems or out-of-range/uninterpretable quantities.