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美国类风湿性关节炎患者中可能与 Janus 激酶抑制剂相互作用药物的处方索赔频率。

Frequency of Prescription Claims for Drugs that May Interact with Janus Kinase Inhibitors Among Patients with Rheumatoid Arthritis in the US.

作者信息

Walton Alison, Paik Jim, Quebe Amanda, Kannowski Carol L, Choong Casey, Anderson Seth, Owensby Justin K

机构信息

College of Pharmacy and Health Sciences, Butler University, Indianapolis, IN, USA.

Eli Lilly and Company, Indianapolis, IN, USA.

出版信息

Rheumatol Ther. 2021 Mar;8(1):599-607. doi: 10.1007/s40744-020-00275-8. Epub 2021 Jan 23.

Abstract

INTRODUCTION

This study describes the frequency of prescription claims for drugs that may interact with Janus kinase (JAK) inhibitors among adult patients with rheumatoid arthritis (RA) in a large US claims database.

METHODS

This observational, retrospective, cross-sectional study of the IBM MarketScan Research Commercial and the Medicare Supplemental Database included adults (≥ 18 years) with ≥ 2 outpatient claims 30 or more days apart or ≥ 1 inpatient visit claim with an RA diagnosis between January 1, 2013 and March 31, 2017 (the index period). During the study period, from January 1, 2013 to March 31, 2018, strong organic anion transporter (OAT3) inhibitors, strong cytochrome P450 (CYP) 3A4 inhibitors, and moderate or strong CYP3A4 inhibitors in combination with strong CYP2C19 inhibitors, were identified as drugs with potential for drug-drug interactions (DDIs) with JAK inhibitors approved for RA treatment in the US. Descriptive statistics were conducted.

RESULTS

A total of 152,853 patients met eligibility criteria. Approximately 76% were women and the median age was 57 years. Of these patients, < 0.1% had a claim for a strong OAT3 inhibitor, and 1% had claims for the combination of a strong CYP3A4 and strong CYP2C19 inhibitor; 3% of patients had a claim for a strong CYP3A4 inhibitor and almost 10% had claims for both a moderate CYP3A4 and a strong CYP2C19 inhibitor.

CONCLUSIONS

Up to 10% of RA patients have been prescribed a drug with a potential JAK interaction. Rheumatologists should consider potential DDIs when managing patients with RA.

摘要

简介

本研究在美国一个大型理赔数据库中描述了类风湿关节炎(RA)成年患者中可能与Janus激酶(JAK)抑制剂相互作用的药物的处方理赔频率。

方法

这项对IBM MarketScan Research Commercial和医疗保险补充数据库进行的观察性、回顾性横断面研究纳入了年龄≥18岁的成年人,他们在2013年1月1日至2017年3月31日(索引期)期间有≥2次间隔30天或更长时间的门诊理赔或≥1次住院就诊理赔且被诊断为RA。在研究期间,即2013年1月1日至2018年3月31日,强有机阴离子转运体(OAT3)抑制剂、强细胞色素P450(CYP)3A4抑制剂以及中度或强CYP3A4抑制剂与强CYP2C19抑制剂的组合,被确定为在美国被批准用于RA治疗的与JAK抑制剂有潜在药物相互作用(DDIs)可能性的药物。进行了描述性统计。

结果

共有152,853名患者符合入选标准。约76%为女性,中位年龄为57岁。在这些患者中,<0.1%有强OAT3抑制剂的理赔记录,1%有强CYP3A4和强CYP2C19抑制剂组合的理赔记录;3%的患者有强CYP3A4抑制剂的理赔记录,近10%的患者有中度CYP3A4抑制剂和强CYP2C19抑制剂两者的理赔记录。

结论

高达10%的RA患者曾被开具过与JAK有潜在相互作用的药物。风湿病学家在管理RA患者时应考虑潜在的药物相互作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfa8/7991043/5c27266b97a3/40744_2020_275_Fig1_HTML.jpg

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