UCB Pharma, 1950 Lake Park Drive, Smyrna, GA, 30080, USA.
Aetion Inc., 5 Penn Plaza, 7th Floor, New York, NY, USA.
Adv Ther. 2023 Oct;40(10):4358-4376. doi: 10.1007/s12325-023-02558-2. Epub 2023 Jul 24.
Psoriasis (PSO), psoriatic arthritis (PsA), axial spondyloarthritis (axSpA), and hidradenitis suppurativa (HS) are chronic inflammatory diseases (CIDs) often diagnosed and treated individually. However, genetic overlaps exist among CIDs, and patients with one are at risk of developing others within the same spectrum. This analysis characterized treatment patterns along with clinical and economic burdens of newly diagnosed CIDs among patients with an additional past diagnosis of PSO, PsA, axSpA, or HS.
This study used MarketScan databases to examine demographics, treatment patterns, and healthcare resource utilization for patients with ≥ 1 claim for PSO or HS or ≥ 2 claims for PsA or axSpA, and continuous enrollment in the year before (baseline period) and following (follow-up period) the date of first diagnosis (incident diagnosis). Comorbidities and new CID diagnoses with a past diagnosis of PSO, PsA, axSpA, or HS, were examined.
The analysis included 298,794 patients (maximum of 1202 patients with ≥ 1 incident diagnoses): 134,233 had incident PSO; 9914 had incident PsA; 115,194 had incident axSpA; and 40,655 had incident HS. Prevalence of ≥ 1 CID diagnosis among patients with past diagnosis of PSO, PsA, axSpA, or HS was 4959/134,233 (3.7%), 5256/9914 (53.0%), 3205/115,194 (2.8%), and 1180/40,655 (2.9%), respectively. In patients with incident axSpA and past PsA diagnosis, incident axSpA and past HS diagnosis, and incident HS and past PSO diagnosis, steroid and opioid use were high across baseline and follow-up periods and use of biologic disease-modifying antirheumatic drugs increased from baseline to follow-up. Disease-related costs increased absolutely and increased or remained high as a proportion of all-cause costs.
Patients with newly diagnosed CIDs and additional past diagnosis of PSO, PsA, axSpA, or HS experienced high treatment utilization and healthcare costs. These findings highlight the need for payers, health technology assessment agencies, clinicians, and other stakeholders to explore the co-management of CIDs, rather than treating them separately.
银屑病（PSO）、银屑病关节炎（PsA）、中轴型脊柱关节炎（axSpA）和化脓性汗腺炎（HS）是常被单独诊断和治疗的慢性炎症性疾病（CIDs）。然而，CIDs 之间存在遗传重叠，患有一种疾病的患者在同一谱系内有发展为其他疾病的风险。本分析描述了新诊断的 CIDs 患者在有既往 PSO、PsA、axSpA 或 HS 诊断的情况下的治疗模式以及临床和经济负担。
本研究使用 MarketScan 数据库，检查了≥1 例 PSO 或 HS 或≥2 例 PsA 或 axSpA 索赔且在首次诊断（发病诊断）日期之前（基线期）和之后（随访期）有连续参保的患者的人口统计学特征、治疗模式和医疗资源利用情况。分析了伴有既往 PSO、PsA、axSpA 或 HS 诊断的合并症和新 CID 诊断。
分析纳入了 298794 例患者（最多有 1202 例患有≥1 例发病诊断）：134233 例患有发病 PSO；9914 例患有发病 PsA；115194 例患有发病 axSpA；40655 例患有发病 HS。既往 PSO、PsA、axSpA 或 HS 诊断的患者中≥1 种 CID 诊断的患病率分别为 4959/134233（3.7%）、5256/9914（53.0%）、3205/115194（2.8%）和 1180/40655（2.9%）。在患有发病 axSpA 和既往 PsA 诊断、发病 axSpA 和既往 HS 诊断以及发病 HS 和既往 PSO 诊断的患者中，基线期和随访期均使用了大量的皮质类固醇和阿片类药物，且生物疾病修正抗风湿药物的使用从基线期增加到随访期。疾病相关成本绝对增加，并且作为全因成本的一部分仍然较高或居高不下。
新发 CIDs 且有既往 PSO、PsA、axSpA 或 HS 诊断的患者经历了较高的治疗利用率和医疗保健费用。这些发现突出表明，需要支付方、卫生技术评估机构、临床医生和其他利益相关者探索 CIDs 的共同管理，而不是单独治疗。
