OBJECTIVES: The objective of this research was to describe secular trends in the use of biologics for the treatment of psoriatic arthritis (PsA) using real-world data.

METHODS: Patients from 6 specialty dermatology networks and 4 integrated delivery networks within the OMNY Health Database with any indication of PsA (diagnosis code: L40.5*) from 2014-2021 were included. Demographic characteristics were tabulated at first PsA diagnosis. Annual percentages of patients with prescriptions for biologics approved for treatment of PsA were computed. Secular trends in annual treatment patterns were described.

RESULTS: Across all years, a total of 7,234 unique PsA patients with prescription or procedure data were included. Patients were 56% female, 14% nonwhite (among known categories), and 38% ages ≥ 60 years with diverse geographical distribution. Etanercept patient use decreased steadily from 7.0% to 1.7%. Conversely, steady increased patient use was observed over the observation period for secukinumab (3.7% in 2016 to 11.5%), certolizumab (0.04% in 2017 to 1.2%), ixekizumab (2.9% in 2017 to 10.6%), and guselkumab (0.8% in 2017 to 7.6%). Increased patient use from 2014 to 2017 followed by a steady decrease until 2021 was observed for adalimumab (9.4% to 16.2% to 12.6%), ustekinumab (5.9% to 8.9% to 3.8%), and infliximab (0.1% to 0.3% to 0.02%). Overall, PsA patient exposure to any biologic therapy exhibited a monotonically linear increase from 20.9% in 2014 to 51.8% in 2021 with an average rate of 4.2% per year.

CONCLUSIONS: Results provide insights into real-world trends in use of biologics for treatment of PsA. Patient use of biologics increased steadily over the observation period with decreased use of some therapies being replaced with increased use of other therapies. Given multiple approved indications for many of these biologics, further analyses would be helpful to try to delineate reason for biologic use for patients with multiple indications.