Drug survival of adalimumab biosimilars in real‐world treatment of psoriasis: A S panish multicenter study

Background In many countries there are strong incentives for initiation of treatment with biosimilars in biologic-naïve patients and non-medical switch of ongoing treatment with originators, but real-world data regarding the outcome of these treatments are scarce. Objectives The objective of this study is to analyze the drug survival of biosimilar adalimumab for treatment of psoriasis in real world clinical practice, and to determine if there are differences between treatment courses with transition from the originator (switch) or initiated with the biosimilar without switching (de novo treatment). Methods A multicenter retrospective observational study was carried out in patients with psoriasis vulgaris, consecutively treated according to clinical practice with biosimilar adalimumab, in 17 Spanish hospitals between October 2016 and February 2021. Drug survival from start of treatment to last visit when discontinuation due to lack/loss of efficacy or adverse events was recorded, was analyzed with Kaplan-Meier curves. Total follow-up was recorded, and univariate and multivariate analyses with Cox proportional hazards regression model were carried out. Results Overall, 581 patients treated with biosimilar adalimumab were included in the study. On univariate analysis, increased drug survival was associated with male sex (HR = 1.874, p<0.001), age ≤ 65 (HR =1.673, p=0.012), coexisting psoriatic arthritis (HR=2.080,p=0.001) and switch from the originator (HR = 6.153, p<0.001). These associations were confirmed in multivariate analysis. Conclusions In Spanish real world clinical practice, drug survival of adalimumab biosimilar is longer in males, younger patients, patients with psoriatic arthritis, and patients who switch from adalimumab originator (compared to biologic-naïve patients who start adalimumab biosimilar as their first biologic). This article is protected by copyright. All rights reserved.