Category: Federal Forum Posters
Purpose: With multitude of biological therapies available for the treatment of moderate-severe psoriasis, different studies have aimed to improve the efficacy and safety of them. However, there is some controversy about which is the best therapeutic option after an anti-TNFᵅ biological first. The main objective of the present work has been evaluate the efficacy of adalimumab and ustekinumab in patients with moderate-severe psoriasis (MSP) previously treated with etancercept.
Methods: An observational, retrospective and unicenter study of 24 month was carried out. Patients with MSP who received treatment with ustekinumab or adalimumab and previously treated with etanercept were included.
Effectiveness of each treatment, evaluated as PASI75 and PASI 90, was analyzed at 16 and 96 weeks of treatment. As secondary objective the cost per responder (total cost/PASI75 or PASI90) of each treatment was analyzed at week 16 and 96. Pharmacological cost was calculated based on the PVL of the medications considered,with the corresponding deduction of 7.5% on the PVL established by Royal Decree 8/2010 2017 and expressed in 2017 euros. The study was clasified for the AEMPS as EPA-OD with the code UST_ADA_2017.
Results: 34 patients were included, 44% received adalimumab and 56% received ustekinumab. In week 16, 84.2% of patients treated with ustekinumab achieved PASI75 vs 46.6% in the group treated with adalimumab (p = 0.02); No differences were found in the percentage of patients who achieved PASI90 in both groups (73.7% vs 40% (p = 0.107)). In week 96, no differences were observed between treatments (63.1% vs 40.0% for both scores). The cost per responder at week 16 of ustekinumab was € 8,466 (PASI75) and € 9,672 (PASI90); while in week 96 it was € 33,890. These results imply a differential cost with respect to adalimumab of -657 € and -956 € (PASI75 / PASI90 respectively) in week 16 and -18.191€ at week 96.
Conclusion: Our results suggest that ustekinumab is more cost-effective than adalimumab for patients previously treated with etanercept; showing only effectiveness differences in the PASI 75 at week 16. This results provides a tool for choosing best treatment option in this kind of patients.