Outcomes of Biologic Use in Asian Compared with Non-Hispanic White Adult Psoriasis Patients from the CorEvitas Psoriasis Registry

Chen Yu; Gang Wang; Russel T Burge; Erjia Ye; Guanshen Dou; Jinnan Li; Ryan W Harrison; Robert R McLean; Samantha J Kerti; Jerry Bagel

doi:10.1007/s13555-022-00843-6

Outcomes of Biologic Use in Asian Compared with Non-Hispanic White Adult Psoriasis Patients from the CorEvitas Psoriasis Registry

Dermatol Ther (Heidelb). 2023 Jan;13(1):187-206. doi: 10.1007/s13555-022-00843-6. Epub 2022 Nov 16.

Authors

Chen Yu¹, Gang Wang², Russel T Burge³, Erjia Ye⁴, Guanshen Dou⁴, Jinnan Li⁴, Ryan W Harrison⁵, Robert R McLean⁵, Samantha J Kerti⁵, Jerry Bagel⁶

Affiliations

¹ Department of Dermatology, Xijing Hospital, The Fourth Military Medical University, No. 127 Changle West Rd, Xi'an, 710032, People's Republic of China.
² Department of Dermatology, Xijing Hospital, The Fourth Military Medical University, No. 127 Changle West Rd, Xi'an, 710032, People's Republic of China. xjwgang@fmmu.edu.cn.
³ Eli Lilly and Company, Indianapolis, IN, USA.
⁴ Eli Lilly and Company, Shanghai, People's Republic of China.
⁵ CorEvitas, LLC, Waltham, MA, USA.
⁶ Psoriasis Treatment Center of New Jersey, East Windsor, NJ, USA.

Abstract

Introduction: Real-world data are limited comparing Asian and White patients with psoriasis using biologic therapy. This study compared the 6-month effectiveness of biologic therapy between Asian and White plaque patients with psoriasis in the CorEvitas Psoriasis Registry.

Methods: Analyses included biologic initiations and 6-month follow-up visits from self-identified Asian (n = 293) and White (n = 2314) patients in the USA/Canada (4/2015-4/2020). Outcomes included: Psoriasis Area Severity Index (PASI) 75, disease activity measures [body surface area (BSA) ≤ 1, BSA ≤ 3, PASI90, PASI100, Investigator's Global Assessment (IGA) 0/1], and patient-reported outcomes [Dermatology Life Quality Index (DLQI) 0/1, itch, fatigue, skin pain, EuroQoL visual analog scale (EQ-VAS), patient global assessment, Work Productivity Activity and Impairment (WPAI) domains]. Unadjusted regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI) for achievement of binary outcomes and difference in mean change in continuous outcomes (β, 95% CI) at 6 months, followed by adjustment for age, sex, body mass index, alcohol, smoking, health insurance, education, comorbidities, scalp psoriasis morphology, psoriatic arthritis, biologic class, previous biologics, and baseline outcome value.

Results: Asians had lower proportions of women (32.8% versus 49.1%) and obesity (27.3% versus 54.5%), and higher proportions on Medicaid (19.9% versus 8.8%), graduated college (50.9% versus 40.1%) and never smoked (67.1% versus 44.1%). In unadjusted analyses, Asians had 52% higher odds of achieving PASI75 versus White patients (OR 1.52; 95% CI 1.15, 2.02). After adjustment, the association was attenuated (OR 1.11; 0.81, 1.52). Secondary outcomes experienced similar patterns except for DLQI: Asians had 33% lower odds of achieving DLQI 0/1 in both the unadjusted (OR 0.67; 0.50, 0.90) and adjusted (OR 0.67; 0.49, 0.92) models.

Conclusion: Unadjusted differences in biologic therapy effectiveness between Asians compared with White patients were likely explained by differences in demographic, lifestyle, and psoriatic disease characteristics between groups. However, Asians still experienced lesser improvements in skin-related quality of life, even after adjustment.

Keywords: Biologic therapy; Effectiveness; Patient registries; Psoriasis; Race/ethnicity; Real-world evidence.