Ho-Mahler Nancy, Turner Beni, Eaddy Michael, Hanke Mark L, Nelson Winnie W
Mallinckrodt Pharmaceuticals, Bedminster, NJ, USA.
Xcenda, Palm Harbor, FL, USA.
Open Access Rheumatol. 2020 Feb 20;12:21-28. doi: 10.2147/OARRR.S231667. eCollection 2020.
Repository corticotropin injection (RCI) is indicated for a number of autoimmune-mediated diseases including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and dermatomyositis (DM)/polymyositis (PM). To better understand the practice patterns and outcomes of RCI in patients with RA, SLE, or DM/PM, we conducted a retrospective medical record analysis.
Participating providers selected deidentified medical records of patients meeting the inclusion criteria (age ≥18 years; physician-reported diagnosis of RA, SLE, or DM/PM; initiation of treatment with RCI between 1/1/2011 and 2/15/2016; ≥3 in-office visits with same site/provider). Collected data spanned 12 months before and after the first prescription date for RCI. Analyses included patient demographics and clinical history, RCI treatment patterns, and physician's impression of change.
Data from 54 patients with RA, 30 patients with SLE, and 8 patients with DM/PM were analyzed. The most frequently reported reasons for initiating RCI were lack of efficacy with prior treatment, acute exacerbation of disease, and use as add-on to ongoing therapy. The most common initial RCI dosing, 80 U twice weekly, was used for 84% of patients with RA, 75% with SLE, and 86% with DM/PM. The mean duration of treatment was 4.8, 6.5, and 6.8 months for RA, SLE, and DM/PM, respectively. Among the 57 patients with data on physician's impression of change with RCI, 78.1% of patients with RA, 94.7% with SLE, and 66.7% with DM/PM had a rating of "improved," and the mean time to best impression of change was 3.4, 4.3, and 3.4 months for RA, SLE, and DM/PM, respectively.
This study reports the real-world patient profile, use patterns, and outcomes of patients who used RCI for the treatment of RA, SLE, and DM/PM. These data can inform appropriate use and clinical expectations when using RCI.
储存型促肾上腺皮质激素注射液（RCI）适用于多种自身免疫介导的疾病，包括类风湿关节炎（RA）、系统性红斑狼疮（SLE）和皮肌炎（DM）/多发性肌炎（PM）。为了更好地了解RCI在RA、SLE或DM/PM患者中的应用模式和疗效，我们进行了一项回顾性病历分析。
参与研究的医疗服务提供者选择了符合纳入标准的患者的去识别化病历（年龄≥18岁；医生报告诊断为RA、SLE或DM/PM；2011年1月1日至2016年2月15日期间开始使用RCI治疗；在同一地点/医疗服务提供者处进行≥3次门诊就诊）。收集的数据涵盖RCI首次处方日期前后12个月。分析内容包括患者人口统计学和临床病史、RCI治疗模式以及医生对病情变化的印象。
分析了54例RA患者、30例SLE患者和8例DM/PM患者的数据。启动RCI最常报告的原因是先前治疗无效、疾病急性加重以及作为正在进行治疗的附加治疗。最常见的初始RCI剂量为每周两次80单位，84%的RA患者、75%的SLE患者和86%的DM/PM患者使用该剂量。RA、SLE和DM/PM的平均治疗持续时间分别为4.8个月、6.5个月和6.8个月。在57例有医生对RCI病情变化印象数据的患者中，78.1%的RA患者、94.7%的SLE患者和66.7%的DM/PM患者的评级为“改善”，RA、SLE和DM/PM达到最佳病情变化印象的平均时间分别为3.4个月、4.3个月和3.4个月。
本研究报告了使用RCI治疗RA、SLE和DM/PM的真实世界患者概况、使用模式和疗效。这些数据可为使用RCI时的合理应用和临床预期提供参考。
