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新诊断多发性硬化症患者的种族和族裔治疗模式

Treatment Patterns by Race and Ethnicity in Newly Diagnosed Persons with Multiple Sclerosis.

作者信息

Geiger Caroline Kelley, Sheinson Daniel, To Tu My, Jones David, Bonine Nicole Gidaya

机构信息

Genentech, Inc., 350 DNA Way, South San Francisco, CA, 94080, USA.

出版信息

Drugs Real World Outcomes. 2023 Dec;10(4):565-575. doi: 10.1007/s40801-023-00387-x. Epub 2023 Sep 21.

Abstract

BACKGROUND

Non-Hispanic Black and Hispanic persons with MS (pwMS) are more likely to experience rapid disease progression and severe disability than non-Hispanic White pwMS; however, it is unknown how the initiation of high-efficacy disease-modifying therapies (DMTs) differs by race/ethnicity. This real-world study describes DMT treatment patterns in newly diagnosed pwMS in the United States (US) overall and by race/ethnicity.

METHODS

This retrospective analysis used the US Optum Market Clarity claims/electronic health records database (January 2015-September 2020). pwMS who were first diagnosed in 2016 or later and initiated any DMT in the two years following diagnosis were included. Continuous enrollment in the claims data for ≥ 12 months before and ≥ 24 months after diagnosis was required. Treatment patterns 2 years after diagnosis were analyzed descriptively overall and by race/ethnicity.

RESULTS

The sample included 682 newly diagnosed and treated pwMS (non-Hispanic Black, n = 99; non-Hispanic White, n = 479; Hispanic, n = 35; other/unknown race/ethnicity, n = 69). The mean time from diagnosis to DMT initiation was 4.9 months in all pwMS. Glatiramer acetate and dimethyl fumarate were the most common first-line DMTs in non-Hispanic Black (28% and 20% respectively) and Hispanic pwMS (31%, 29%); however, glatiramer acetate and ocrelizumab were the most common in non-Hispanic White pwMS (33%, 18%). Use of first-line high-efficacy DMTs was limited across all race/ethnicity subgroups (11-29%), but uptake increased in non-Hispanic Black and White pwMS over the study period.

CONCLUSION

Use of high-efficacy DMTs was low across all race/ethnicity subgroups of newly diagnosed pwMS in the US, including populations at a greater risk of experiencing rapid disease progression and severe disability.

摘要

背景

与非西班牙裔白人多发性硬化症患者(pwMS)相比,非西班牙裔黑人和西班牙裔pwMS更有可能经历疾病快速进展和严重残疾;然而,高效疾病修饰疗法(DMTs)的起始使用在种族/民族方面存在何种差异尚不清楚。这项真实世界研究描述了美国新诊断的pwMS总体以及按种族/民族划分的DMT治疗模式。

方法

这项回顾性分析使用了美国Optum市场清晰度索赔/电子健康记录数据库(2015年1月至2020年9月)。纳入2016年或之后首次诊断且在诊断后两年内开始使用任何DMT的pwMS。要求在诊断前连续纳入索赔数据≥12个月,诊断后≥24个月。对诊断后2年的治疗模式进行总体和按种族/民族的描述性分析。

结果

样本包括682名新诊断并接受治疗的pwMS(非西班牙裔黑人,n = 99;非西班牙裔白人,n = 479;西班牙裔,n = 35;其他/未知种族/民族,n = 69)。所有pwMS从诊断到开始使用DMT的平均时间为4.9个月。醋酸格拉替雷和富马酸二甲酯分别是非西班牙裔黑人(分别为28%和20%)和西班牙裔pwMS(31%,29%)中最常见的一线DMT;然而,醋酸格拉替雷和奥瑞珠单抗在非西班牙裔白人pwMS中最常见(33%,18%)。在所有种族/民族亚组中,一线高效DMT的使用都有限(11 - 29%),但在研究期间,非西班牙裔黑人和白人pwMS中的使用有所增加。

结论

在美国新诊断的pwMS的所有种族/民族亚组中,包括疾病快速进展和严重残疾风险较高的人群,高效DMT的使用都很低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a72a/10730787/b9fcde69ab62/40801_2023_387_Fig1_HTML.jpg

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