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TOPLINE:

Black patients with psoriasis are less likely to switch biologic therapies than patients in other racial and ethnic groups, indicating possible differences in treatment patterns.

METHODOLOGY:

• Data from the CorEvitas Psoriasis Registry have found that response rates with biologics in patients with moderate to severe psoriasis are similar across racial/ethnic groups, but information on variations in treatment patterns among these groups is limited.
• This study compared discontinuation and switching rates for biologic treatments in 5500 patients with psoriasis of diverse racial/ethnic backgrounds in the CorEvitas Psoriasis Registry (April 2015 to March 2021).
• Based on self-identified race and ethnicity, patients were in the following groups: White (n = 4128), Black (n = 193), Asian (n = 460), Hispanic (n = 535), and "other" (n = 184).
• Patients initiated an interleukin (IL)-17 inhibitor, IL-12/23 inhibitor, IL-23 inhibitor, or a tumor necrosis factor inhibitor.
• Frequencies of biologic discontinuations and switches (stopping a biologic and starting another, adding another biologic, or adding a nonbiologic therapy) within 6 months after starting treatment were assessed and compared among these groups.

TAKEAWAY:

• The frequency of biologic discontinuations by 6 months was similar among the racial and ethnic groups (1.7%-4.1%), but the frequency of biologic switching significantly varied among the groups: 6.7% among Black patients compared with 13.7% among Asians, 12% among Hispanics, 16% among Whites, and 13% among those classified as "other" (P < .01).
• Black patients were 57% less likely to switch therapy compared with White patients (adjusted relative risk, 0.43; 95% CI, 0.26-0.73).
• Among patients who switched therapies, Black patients had the lowest rate of switching to a different biologic and the highest rate of adding a nonbiologic therapy.
• Over 90% of the switching occurred because of a poor response to therapy.

IN PRACTICE:

While the results should be "interpreted cautiously," the authors wrote, their findings "suggest different management strategies are utilized for patients of different race/ethnicity." The reasons for this "may be partially explained by a greater level of unfamiliarity and apprehension with biologics among Black patients compared to White, representation in clinical research or physician-patient preferences," and different presentations of psoriasis in different racial/ethnic groups, they added.

SOURCE:

The study was led by Clinton W. Enos, MD, of the Department of Dermatology at Eastern Virginia Medical School, Norfolk, Virginia. It was published online in the Journal of the American Academy of Dermatology.

LIMITATIONS:

The authors noted the limited sample sizes in the non-White groups, which may limit the generalizability of the findings. 

DISCLOSURES:

The study was funded by CorEvitas and supported through a partnership between the CorEvitas Psoriasis Registry and the National Psoriasis Foundation. Enos is an investigator for Amgen and Castle Biosciences; another author has received grant/research support from and is a consultant to several pharmaceutical companies, three authors were from CorEvitas, and the remaining authors declared no conflicts of interest.