Chao Li’s research while affiliated with AbbVie and other places

Background: Psoriatic patients often experience issues with lack of therapeutic efficacy and intolerance, which may result in high levels of treatment switching. This study examined real-world, 12-month switch rates and patient characteristics associated with treatment switching in patients with both PsO and PsA treated with risankizumab and other biologics. Methods: This analysis used the Merative MarketScan® Databases (2016–2024) to identify adults from the US who had ≥2 medical claims for PsO, 1 claim for PsA and did not have any other autoimmune condition in the 6 months pre- and post-index period. Patients must have initiated a PsO-approved biologic and have continuous insurance benefits for ≥6 months before and ≥12 months after the biologic initiation date. Switch rates were defined as the proportion of patients who switched to a new biologic or advanced oral in the 12-month follow-up after treatment initiation. Discontinuation and non-adherence were not included in the switch definition. Switch rates were compared between biologics with sufficient sample size (n 100). Univariate logistic regression analyses were conducted to compare switch rates for risankizumab versus other biologics. Multivariate logistic regression analyses were performed to examine the impact of baseline demographic and treatment characteristics on switch rates and determine predictors of switching. Results: Among 3032 patients, mean age at baseline was 47.4 (SD 10.78) years and 55.4% were female. Overall treatment switch rate at 12-month follow-up was 24.9% (756/3032). Of those treatments with sufficient sample size, patients receiving risankizumab had the lowest switch rate (7.3%; 15/206) compared to all other biologics, including other IL-23 inhibitors (guselkumab 16.7%, P=0.0029), IL-17 inhibitors (ixekizumab 22.4%, P<0.0001; secukinumab 23.7%, P<0.0001), TNF inhibitors (adalimumab 28.3%, P<0.0001; etanercept 35.8%, P<0.0001), and IL-12/23 inhibitors (ustekinumab 22.4%, P<0.0001). Results were similar in multivariate logistic regression analyses after adjusting for variations in baseline characteristics. Predictors of switching at 12 months included female sex (adjusted odds ratio [aOR] [95% CI]: 1.63 [1.36, 1.94]; P<0.0001), baseline anxiety or depression (aOR [95% CI]: 1.47 [1.21, 1.80]; P=0.0001), baseline major adverse cardiovascular event (aOR [95% CI]: 1.47 [1.15, 1.88]; P=0.0023), and prior targeted immunomodulator (TIM) use (aOR [95% CI]: 1.45 [1.20, 1.74]; P=0.0001). Conclusion: In a real-world setting, switching was common among psoriasis patients with PsA. Risankizumab showed the lowest rate of treatment switching at 12 months, compared with all other biologics. Sex, comorbidities, and prior TIM use were predictors of higher switch rates.

Hidradenitis suppurativa (HS) is a chronic inflammatory follicular skin condition that is associated with significant psychosocial and economic burden and a diminished quality of life and work productivity. Accurate diagnosis of HS is challenging due to its unknown etiology, which can lead to underdiagnosis or misdiagnosis that results in increased patient and healthcare system burden. We applied machine learning (ML) to a medical and pharmacy claims database using data from 2000 through 2018 to develop a novel model to better understand HS underdiagnosis on a healthcare system level. The primary results demonstrated that high-performing models for predicting HS diagnosis can be constructed using claims data, with an area under the curve (AUC) of 81%–82% observed among the top-performing models. The results of the models developed in this study could be input into the development of an impact of inaction model that determines the cost implications of HS diagnosis and treatment delay to the healthcare system.

Introduction: Psoriasis (PsO) is a chronic, inflammatory skin disorder that affects 1%–4% of adults in the US. While PsO typically affects the skin, it is also associated with other systemic comorbidities, such as psoriatic arthritis, cardiometabolic disease, diabetes, and obesity. Switching therapies is common in patients with PsO due to poor treatment outcomes, such as lack of efficacy or safety/tolerability issues that are notably more pronounced in refractory patients. This study aims to quantify real-world switch rates for patients with PsO treated with risankizumab, stratified by body mass index (BMI) categories. Methods: The Optum® Market Clarity data, which includes insurance claims linked with electronic medical records data, was used to identify biologic-naïve adult patients who initiated risankizumab between May 1, 2019 and September 30, 2022, with ≥1 PsO diagnosis (ICD codes) on or prior to biologic initiation. Patients had ≥6 months of continuous insurance benefits pre- and ≥12 months post-biologic initiation, and BMI data available on or in the 12 months before the start of risankizumab. Assessed outcomes included switch rates over 12 months among all risankizumab initiators and stratified by BMI category (BMI <25 Kg/m2, 25 to <30 Kg/m2, ≥30 Kg/m2). Results: A total of 367 patients were included in this analysis. The mean (SD) age of patients was 47.7 (14.3) years, 194 (52.9%) were female, 20 (5.5%) were Black, and 305 (83.1%) were White. Of all patients, 71 (19.4%) had a BMI of <25 Kg/m2, 111 (30.2%) had a BMI of 25 to <30 Kg/m2, and 185 (50.4%) had a BMI ≥30 Kg/m2. The switch rate by 12 months for all patients initiating risankizumab was 3.8%. Switch rates by BMI category were 5.6% (BMI <25 Kg/m2), 2.7% (BMI 25 to <30 Kg/m2), and 3.8% (BMI ≥30 Kg/m2); there were no significant differences in switch rates between BMI categories (P = 0.589 from Fisher's exact test). Conclusions: In this real-world study, treatment patterns through 12 months among patients initiating risankizumab were consistent regardless of BMI category.

Background Switching therapies is common for patients with psoriasis. Objective To quantify real-world switching rates and characteristics among patients initiating biologics over 24 months. Methods Patients aged ≥18 years with ≥2 confirmed psoriasis diagnoses who initiated a new biologic were identified from a US-payer claims database (Merative® MarketScan®) Switching rates were reported over 24 months using Kaplan–Meier survival analysis, and multivariable Cox regression analyses were performed to identify associated patient characteristics. Results A total of 7997 patients were included, with overall treatment switch rates at 14.4% at 12 months and 26.0% at 24 months. IL-23 inhibitors were associated with the lowest risk of switching compared with TNF, IL-17, and IL-12/23 inhibitors over 24 months (p < 0.0001). Switch rates varied between specific biologics, with the lowest switch rates observed for patients treated with risankizumab at 8.5% followed by guselkumab at 15.7% over 24 months. Prior targeted immune modulator use, age, and female gender were predictors of switching (adjusted hazard ratio; 1.23, 1.31, and 1.40, respectively; p ≤ 0.0005). Limitations Claims data may be subject to data errors and reasons for switching cannot be determined. Conclusion Switching was common in psoriasis patients using biologics over 24 months, with the lowest risk of switching observed with IL-23 inhibitors.