Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
Optum, Eden Prairie, MN, USA.
Adv Ther. 2021 Jun;38(6):2921-2934. doi: 10.1007/s12325-021-01677-y. Epub 2021 Mar 24.
This retrospective analysis aimed to characterize patients with migraine initiating erenumab and the shifting or trend of patient characteristics over time in a real-world setting.
Adult patients with at least one erenumab written prescription/administration between May 1, 2018 and September 30, 2019 were identified from the Optum De-identified Electronic Health Record (EHR) database (index date = date of the first erenumab prescription/administration). Patient demographics and characteristics, acute and preventive medications used prior to initiation of erenumab, and the initial prescriber specialty were examined. In addition, the shifting or trends of patient characteristics over time were analyzed among subgroups of patients based on when they initiated erenumab.
A total of 14,774 eligible patients who met inclusion and exclusion criteria were included in the analysis. Most patients were female (86.4%), average age 46.3 (standard deviation [SD] = 13.1) years, Caucasian (88.7%), non-Hispanic (91.8%), and commercially insured (59.8%) at the index date. During the 12-month pre-index period, commonly observed selected comorbid conditions included anxiety (30.6%), depression (28.2%), and cardiovascular diseases (26.4%), and the mean (SD) Elixhauser comorbidity score was 1.7 (5.5). The most common provider specialty at erenumab initiation was neurologist/headache specialist (46.5%). Over time, there was a decrease in mean baseline Elixhauser comorbidity score at erenumab initiation, an increase in general practitioners prescribing initial erenumab, and increased utilization in patients with less severe migraine overall (a proxy of the declining trend in chronic migraine and triptan use).
Early use of erenumab post approval focused on patients with more severe disease and a high comorbidity index rating. Over time, utilization of this preventive medication occurred in a broader population of patients with migraine, with increased use by general practitioners and those outside of headache centers.
本回顾性分析旨在描述在真实环境中开始使用依瑞奈单抗的偏头痛患者的特征，以及随着时间的推移患者特征的变化或趋势。
从 Optum 去识别电子健康记录（EHR）数据库中确定了 2018 年 5 月 1 日至 2019 年 9 月 30 日期间至少有一次依瑞奈单抗处方/管理记录的成年患者（索引日期=依瑞奈单抗首次处方/管理日期）。检查了患者人口统计学和特征、开始使用依瑞奈单抗之前使用的急性和预防性药物以及初始开处方医生的专业。此外，还根据患者开始使用依瑞奈单抗的时间，分析了不同亚组患者的特征变化或趋势。
共纳入 14774 名符合纳入和排除标准的合格患者进行分析。大多数患者为女性（86.4%），平均年龄为 46.3（标准差[SD] = 13.1）岁，白种人（88.7%），非西班牙裔（91.8%），索引日期时商业保险（59.8%）。在 12 个月的预索引期内，常见的选定合并症包括焦虑症（30.6%）、抑郁症（28.2%）和心血管疾病（26.4%），Elixhauser 合并症评分平均值（SD）为 1.7（5.5）。依瑞奈单抗起始时最常见的医生专业是神经病学/头痛专家（46.5%）。随着时间的推移，依瑞奈单抗起始时的平均基线 Elixhauser 合并症评分有所下降，开处方初始依瑞奈单抗的普通医生数量有所增加，总体上偏头痛症状较轻的患者的利用率有所增加（代表慢性偏头痛和曲坦类药物使用减少的趋势）。
依瑞奈单抗获得批准后的早期使用主要针对疾病更严重和合并症指数评分较高的患者。随着时间的推移，这种预防性药物在更多偏头痛患者中得到了应用，普通医生和头痛中心以外的医生的使用量有所增加。
