Patients with psoriasis (PsO) or psoriatic arthritis (PsA) who initiated immunosuppressant therapy with apremilast during the COVID-19 pandemic in a telehealth conference vs in-person visit had similar medication adherence and persistence for 6 months, according to study results published in Dermatologic Therapy.
Researchers conducting a retrospective cohort study sourced administrative claims data from the Merative MarketScan Commercial and Medicare Supplemental databases for their analysis.
Patients were 18 years of age and older on the index date, which was the date of the first apremilast claim during the identification period (April 2020 to June 30 2020). The baseline period was 6 months prior to the index date and the follow-up period was 6 months after the index date.
The study outcomes were adherence and persistence to apremilast therapy, which the researchers noted is simple to initiate and requires no prescreening or laboratory monitoring. Adherence was measured as the proportion of days covered (PDC) during the follow-up period, with full treatment adherence defined as PDC of 0.80 or higher. Apremilast persistence was defined as continuous use from the index date to the end of available days’ supply of apremilast without a gap of 60 days or longer.
A total of 505 patients with PsO or PsA initiated apremilast therapy during the study period; 141 initiated treatment in a telehealth setting and 364 initiated treatment following an in-person visit (P =.272). The mean age of patients was 46.8 years in the telehealth group vs 48 years in the in-person group (P =.304). In the telehealth group, 61.7% of patients were women, compared with 56.3% in the in-person group.
During the 6-month follow-up period, patients in the telehealth group had a mean PDC (SD) similar to that of the in-person group (0.695 [0.308] vs 0.728 [0.290]; P =.272). The proportion of patients with full treatment adherence was also similar between the 2 groups (telehealth, 49.6% vs in-person, 56%; P =.195).
Treatment persistence among patients who initiated apremilast with a telehealth visit was similar to that among patients who initiated apremilast therapy with an in-person visit (62.4% vs 66.2%, respectively; P =.422).
Patients who initiated apremilast via a telehealth visit had similar risks for treatment discontinuation (hazard ratio, 1.02; 95% CI, 0.79-1.32; P =.875] and rates of full adherence (odds ratio [OR] 0.80; 95% CI, 0.52-1.21; P =.288) compared with patients who initiated apremilast in person, after adjustment for age, sex, geographic region of the US, physician specialty at index visit, diagnosis at index visit (PsA vs PsO), and systemic nonbiologic or biologic use at baseline.
Older patients (OR, 1.03; 95% CI, 1.01-1.04; P <.001) and those who had PsO at the index visit (OR, 0.51; 95% CI, 0.29-0.91; P =.022) were more likely to be fully adherent than their younger counterparts.
Limitations include the fact that this retrospective observational analysis used administrative claims, which do not specify whether medications are taken as prescribed. Also, the study was limited to individuals with commercial and Medicare supplemental insurance coverage.
“These findings suggest that patients with PsO and patients with PsA initiating apremilast may be effectively managed via telehealth visits, although future research is needed to assess the impact of additional clinical and treatment factors (such as type of psoriasis and concomitant therapy) on effective management via telehealth,” the researchers concluded.
Disclosure: This study was funded by Amgen, Inc. Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
This article originally appeared on Dermatology Advisor
Das AK, Chang E, Paydar C, Broder MS, Orroth KK, Cordey M. Apremilast adherence and persistence in patients with psoriasis and psoriatic arthritis in the telehealth setting versus the in-person setting during the COVID-19 pandemic. Dermatol Ther (Heidelb). Published online July 1, 2023. doi:10.1007/s13555-023-00967-3