Rosmarin David, Soliman Ahmed M, Li Chao
Department of Dermatology, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 139, Indianapolis, IN, 46202, USA.
AbbVie Inc., North Chicago, IL, USA.
Dermatol Ther (Heidelb). 2023 Sep;13(9):2079-2091. doi: 10.1007/s13555-023-00983-3. Epub 2023 Aug 7.
Vitiligo is an autoimmune disorder resulting in skin depigmentation, with limited approved treatment options. This study evaluated medication utilization and treatment patterns among patients in the first year following vitiligo diagnosis.
This retrospective analysis of claims data from the Merative MarketScan Research Databases included patients aged ≥ 12 years newly diagnosed with vitiligo. Patients were identified between October 1, 2016, and April 30, 2021, and had ≥ 12 months of continuous enrollment pre- and post-vitiligo diagnosis. Medication use, treatment line of therapy, time to and number of medication claims, and length of therapy were reported in the 12 months post-vitiligo diagnosis. Results are reported separately for treatment initiators post-vitiligo diagnosis, patients with moderate-to-severe vitiligo, and adolescents (aged 12-17 years).
A total of 19,335 patients were included in the analysis, with half (N = 9648, 49.9%) not receiving any treatment during the 12-month follow-up. Switching was minimal among treatment initiators (N = 5845) in the 12 months post-vitiligo diagnosis, with the most frequent first-line treatments being high-potency topical corticosteroids (25.4%), oral corticosteroids (23.1%), and topical calcineurin inhibitors (TCI, 14.7%). Adolescents initiating treatment (N = 486) most frequently received TCI (30.9%) as first-line therapy. Patients with moderate-to-severe vitiligo (N = 3462) were very likely to receive treatment during follow-up, with only 1.5% not receiving treatment. Among patients with no vitiligo treatment prior to diagnosis, time to first medication claim ranged from 51.9 days (standard deviation [SD], 84.0) for TCI to 178.6 days (SD 116.0) for systemic immunosuppressants; mean total days supplied ranged from 14.4 days (SD 27.1) for oral corticosteroids to 121.0 (SD 114.0) for immunosuppressants.
In this real-world study, a high proportion of patients did not receive any treatment. Among those receiving treatment, most were unlikely to switch or use a combination of treatments within the first year of vitiligo diagnosis.
白癜风是一种导致皮肤色素脱失的自身免疫性疾病，获批的治疗选择有限。本研究评估了白癜风诊断后第一年患者的药物使用情况和治疗模式。
这项对来自默克多市场扫描研究数据库的索赔数据的回顾性分析纳入了年龄≥12岁的新诊断为白癜风的患者。在2016年10月1日至2021年4月30日期间识别出患者，且在白癜风诊断前后有≥12个月的连续参保记录。报告了白癜风诊断后12个月内的药物使用、治疗线数、药物索赔时间和数量以及治疗时长。分别报告了白癜风诊断后开始治疗的患者、中度至重度白癜风患者和青少年（12 - 17岁）的结果。
共有19335名患者纳入分析，其中一半（N = 9648，49.9%）在12个月的随访期间未接受任何治疗。白癜风诊断后12个月内，开始治疗的患者（N = 5845）中换药情况极少，最常用的一线治疗药物为强效外用糖皮质激素（25.4%）、口服糖皮质激素（23.1%）和外用钙调神经磷酸酶抑制剂（TCI，14.7%）。开始治疗的青少年（N = 486）最常接受TCI（30.9%）作为一线治疗。中度至重度白癜风患者（N = 3462）在随访期间很可能接受治疗，只有1.5%未接受治疗。在诊断前未接受白癜风治疗的患者中，首次药物索赔时间从TCI的51.9天（标准差[SD]，84.0）到全身免疫抑制剂的178.6天（SD 116.0）不等；平均供应总天数从口服糖皮质激素的14.4天（SD 27.1）到免疫抑制剂的121.0天（SD 114.0）不等。
在这项真实世界研究中，很大一部分患者未接受任何治疗。在接受治疗的患者中，大多数在白癜风诊断后的第一年内不太可能换药或联合使用多种治疗方法。
