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COVID-19 大流行期间接受靶向免疫调节剂治疗的免疫介导性疾病患者的医疗资源利用情况:一项回顾性理赔分析。

Healthcare Resource Use in Patients with Immune-Mediated Conditions Treated with Targeted Immunomodulators During COVID-19 Pandemic: A Retrospective Claims Analysis.

机构信息

Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA.

AbbVie Inc., North Chicago, IL, USA.

出版信息

Adv Ther. 2021 Oct;38(10):5302-5316. doi: 10.1007/s12325-021-01906-4. Epub 2021 Sep 13.

Abstract

INTRODUCTION

The impact of the COVID-19 pandemic on routine medical care may result in altered healthcare resource use in patients with immune-mediated conditions. The aim of this study was to determine the impact of treatment interruptions in patients with and without COVID-19 infections who were treated with targeted immunomodulators (TIMs) in the USA.

METHODS

Data from the IBM MarketScan Research Databases were analyzed in patients with immune-mediated conditions from January 1, 2018, through December 31, 2020. Healthcare resource use (HCRU) including hospitalizations, emergency department (ED) visits, in-person outpatient visits, and respiratory outcomes was assessed in a cohort of patients without COVID-19 who had uninterrupted versus interrupted TIM use. The impact of treatment interruption on HCRU and respiratory outcomes was also evaluated in a cohort of patients with COVID-19. Results from adjusted logistic regression were reported as adjusted odds ratios (aORs) with 95% confidence intervals.

RESULTS

Approximately 25% of patients in both the COVID-19 (N = 787) and non-COVID-19 cohorts (N = 77,178) experienced interruptions in TIM therapy. In the non-COVID-19 cohort, the likelihood of being hospitalized was 20% less in patients with uninterrupted versus interrupted TIM use (aOR = 0.80, 95% CI 0.71-0.90). Patients with uninterrupted TIM use had a similar likelihood of an ED visit (aOR = 0.99, 95% CI 0.91-1.08) and respiratory outcome (aOR = 0.97, 95% CI 0.71-1.31) versus patients with interrupted TIM use. The likelihood of having an in-person outpatient visit was 87% greater in patients with uninterrupted versus interrupted TIM use (aOR = 1.87, 95% CI 1.81-1.94). Similar findings were observed in the COVID-19 cohort.

CONCLUSION

This analysis of real-world claims data showed that uninterrupted TIM use was not associated with an increased likelihood of hospitalizations, ED visits, or negative respiratory outcomes compared to interrupted TIM use among patients with immune-mediated conditions, regardless of COVID-19 diagnosis.

摘要

简介

COVID-19 大流行对常规医疗的影响可能导致免疫介导疾病患者的医疗资源使用发生变化。本研究的目的是确定在美国接受靶向免疫调节剂(TIMs)治疗的 COVID-19 感染和非 COVID-19 感染患者中断治疗的影响。

方法

从 2018 年 1 月 1 日至 2020 年 12 月 31 日,分析 IBM MarketScan 研究数据库中的免疫介导疾病患者数据。在未感染 COVID-19 的患者队列中,评估了无 COVID-19 且 TIM 未中断使用与 TIM 中断使用的患者的医疗资源使用(HCRU),包括住院、急诊(ED)就诊、门诊就诊和呼吸道结局。还评估了 COVID-19 患者治疗中断对 HCRU 和呼吸道结局的影响。调整后的逻辑回归结果以调整后的优势比(aOR)和 95%置信区间报告。

结果

COVID-19 队列(N=787)和非 COVID-19 队列(N=77178)中约有 25%的患者经历了 TIM 治疗中断。在非 COVID-19 队列中,与 TIM 中断使用的患者相比,TIM 未中断使用的患者住院的可能性降低 20%(aOR=0.80,95%CI 0.71-0.90)。与 TIM 中断使用的患者相比,TIM 未中断使用的患者 ED 就诊(aOR=0.99,95%CI 0.91-1.08)和呼吸道结局(aOR=0.97,95%CI 0.71-1.31)的可能性相似。与 TIM 中断使用的患者相比,TIM 未中断使用的患者门诊就诊的可能性增加了 87%(aOR=1.87,95%CI 1.81-1.94)。在 COVID-19 队列中也观察到了类似的发现。

结论

这项真实世界理赔数据的分析表明,与 TIM 中断使用相比,免疫介导疾病患者无论 COVID-19 诊断如何,TIM 持续使用与住院、ED 就诊或负面呼吸道结局的可能性增加无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c560/8478754/3496fde9a2d1/12325_2021_1906_Fig1_HTML.jpg

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