阿达木单抗患者支持项目对强直性脊柱炎临床结局的影响：COMPANION研究结果
Impact of the Adalimumab Patient Support Program on Clinical Outcomes in Ankylosing Spondylitis: Results from the COMPANION Study.
作者信息
Bessette Louis, Lebovic Gerald, Millson Brad, Charland Katia, Donepudi Krishna, Gaetano Tania, Remple Valencia, Latour Martin G, Gazel Sandra, Laliberté Marie-Claude, Thorne Carter
机构信息
Department of Medicine, Laval University, Quebec, QC, Canada.
Applied Health Research Centre, St. Michael's Hospital, Toronto, ON, Canada.
出版信息
Rheumatol Ther. 2018 Jun;5(1):75-85. doi: 10.1007/s40744-018-0109-3. Epub 2018 Apr 9.
INTRODUCTION
Adalimumab (ADA) is a tumor necrosis factor (TNF)-alpha inhibitor indicated for the treatment of inflammatory autoimmune diseases, including ankylosing spondylitis (AS). Patients receiving ADA in Canada are eligible to enroll in the AbbVie Care™ patient support program (AC-PSP), which provides personalized services, including care coach calls (CCCs). We estimated the likelihood of controlled disease in a cohort of AS patients treated with ADA enrolled in the AC-PSP and who received CCCs versus those who did not.
METHODS
A longitudinal analysis using de-identified aggregate-level data collected through the AC-PSP was performed. A probabilistic matching algorithm was used to link patient-level records from the AC-PSP database to records from the QuintilesIMS longitudinal prescription transactions database. Patients were indexed on the date of their first prescription of ADA between January 2010 and October 2015. The AC-PSP database included patient assessments of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), a measure of disease activity. Eligible patients had a baseline BASDAI assessment performed between 90 days before and 30 days after the index date, and a follow-up BASDAI assessment 6-18 months later. Poisson regression was used to estimate the adjusted relative risk (RR) of controlled disease (BASDAI < 4) at the time of follow-up, comparing patients who received CCCs with those who did not.
RESULTS
In total 249 AS patients met eligibility criteria, and 123 (49%) received CCCs. Of the 249 patients, 184 (74%) had controlled disease (BASDAI < 4) at follow-up assessment, 98 (80%) in the CCC group and 86 (68%) in the no CCC group. Multivariable regression analysis demonstrated a 23% increased likelihood of controlled disease in patients who received CCCs relative to those who did not (RR = 1.23; 95% confidence interval, 1.06-1.42; p = 0.0055).
CONCLUSION
AS patients receiving tailored services through the AC-PSP in the form of CCCs have an increased likelihood of controlled disease within 6-18 months.
FUNDING
AbbVie.
简介
阿达木单抗（ADA）是一种肿瘤坏死因子（TNF）-α抑制剂，用于治疗包括强直性脊柱炎（AS）在内的炎症性自身免疫性疾病。在加拿大接受ADA治疗的患者有资格参加艾伯维关爱计划™（AC-PSP）患者支持项目，该项目提供个性化服务，包括护理指导电话（CCC）。我们评估了参加AC-PSP并接受CCC的ADA治疗AS患者队列与未接受CCC的患者队列中疾病得到控制的可能性。
方法
使用通过AC-PSP收集的去识别化汇总数据进行纵向分析。采用概率匹配算法将AC-PSP数据库中的患者层面记录与昆泰纵向处方交易数据库中的记录相链接。患者以2010年1月至2015年10月期间首次开具ADA处方的日期为索引。AC-PSP数据库包括患者对巴斯强直性脊柱炎疾病活动指数（BASDAI）的评估，这是一种疾病活动度测量指标。符合条件的患者在索引日期前90天至后30天内进行了基线BASDAI评估，并在6至18个月后进行了随访BASDAI评估。使用泊松回归估计随访时疾病得到控制（BASDAI＜4）的调整相对风险（RR），比较接受CCC的患者与未接受CCC的患者。
结果
共有249例AS患者符合入选标准，其中123例（49%）接受了CCC。在这249例患者中，184例（74%）在随访评估时疾病得到控制，CCC组中有98例（80%），无CCC组中有86例（68%）。多变量回归分析表明，接受CCC的患者疾病得到控制的可能性比未接受CCC的患者高23%（RR = 1.23；95%置信区间，1.06 - 1.42；p = 0.0055）。
结论
通过AC-PSP以CCC形式接受定制服务的AS患者在6至18个月内疾病得到控制的可能性增加。
资助
艾伯维。
Zotero 插件