Bindra Jas, Chopra Ishveen, Hayes Kyle, Niewoehner John, Panaccio Mary Prince, Wan George J
Falcon Research Group, North Potomac, MD, USA.
Manticore Consultancy, Bethesda, MD, USA.
Ther Clin Risk Manag. 2024 Feb 9;20:83-94. doi: 10.2147/TCRM.S438174. eCollection 2024.
Sarcoidosis is common among African Americans in the United States. Acthar Gel is a viable option for the treatment of advanced symptomatic sarcoidosis. This study examined patient characteristics, Acthar Gel utilization, co-medication use, and treatment response based on physicians' assessments among African Americans versus non-African Americans with advanced symptomatic sarcoidosis.
Data from the medical charts of patients were used. During data collection, patients had either completed ≥1 course or received treatment with Acthar Gel for ≥6 months.
This study comprised 168 African Americans and 104 non-African Americans. On average, the time since the first diagnosis of sarcoidosis was slightly longer among African Americans than non-African Americans (5.2 versus 4.3 years). Skin, heart, eyes, and joints were the most common extrapulmonary sites involved among both race groups. Shortness of breath, fatigue, bone and joint pain, and wheezing/coughing were the most frequent symptoms among both race groups. A higher proportion of African Americans versus non-African Americans were first-time Acthar Gel users and had not completed treatment during data collection. Patients in both race groups with higher starting doses of Acthar Gel therapy had a shorter treatment duration and vice-versa. A significantly lower proportion of patients among both race groups were on any co-medication after Acthar Gel initiation (p<0.0001). Further, a higher proportion of African Americans versus non-African Americans had a reduction in any co-medication use after Acthar Gel initiation. The mean daily dose of prednisone decreased among African Americans (18.5 to 10.1 mg) and non-African Americans (17.6 to 10.0 mg) after Acthar Gel initiation. Improvement in patient health status and overall symptoms was similar for both race groups.
Findings suggest that Acthar Gel improves health outcomes for patients with sarcoidosis, which could help to alleviate health disparities among African Americans, who are disproportionately affected by this disease.
结节病在美国非裔美国人中很常见。促肾上腺皮质激素凝胶(Acthar Gel)是治疗晚期症状性结节病的一种可行选择。本研究基于医生对晚期症状性结节病的非裔美国人和非非裔美国人的评估,考察了患者特征、促肾上腺皮质激素凝胶的使用情况、联合用药情况以及治疗反应。
使用患者病历数据。在数据收集期间,患者已完成≥1个疗程或接受促肾上腺皮质激素凝胶治疗≥6个月。
本研究包括168名非裔美国人和104名非非裔美国人。平均而言,非裔美国人自首次诊断结节病以来的时间比非非裔美国人略长(5.2年对4.3年)。皮肤、心脏、眼睛和关节是两个种族组中最常见的肺外受累部位。呼吸急促、疲劳、骨和关节疼痛以及喘息/咳嗽是两个种族组中最常见的症状。与非非裔美国人相比,首次使用促肾上腺皮质激素凝胶且在数据收集期间未完成治疗的非裔美国人比例更高。两个种族组中促肾上腺皮质激素凝胶治疗起始剂量较高的患者治疗持续时间较短,反之亦然。两个种族组中在开始使用促肾上腺皮质激素凝胶后使用任何联合药物的患者比例显著较低(p<0.0001)。此外,与非非裔美国人相比,开始使用促肾上腺皮质激素凝胶后减少联合用药的非裔美国人比例更高。开始使用促肾上腺皮质激素凝胶后,非裔美国人(从18.5毫克降至10.1毫克)和非非裔美国人(从17.6毫克降至10.0毫克)的泼尼松平均日剂量均降低。两个种族组患者的健康状况和总体症状改善情况相似。
研究结果表明,促肾上腺皮质激素凝胶可改善结节病患者的健康结局,这可能有助于缓解非裔美国人之间的健康差距,非裔美国人受这种疾病的影响尤为严重。