Danve Abhijeet, Vadhariya Aisha, Lisse Jeffrey, Cholayil Arjun, Bansal Neha, Bello Natalia, Bakewell Catherine
Yale School of Medicine, New Haven, CT, USA.
Eli Lilly and Company, Indianapolis, IN, USA.
Rheumatol Ther. 2024 Oct;11(5):1333-1345. doi: 10.1007/s40744-024-00710-0. Epub 2024 Aug 20.
Real-world data on ixekizumab utilization in axial spondyloarthritis (axSpA) are limited. We evaluated ixekizumab treatment patterns and health care resource utilization (HCRU) in patients with axSpA using United States Merative L.P. MarketScan Claims Databases.
This retrospective cohort study included adults with axSpA who initiated ixekizumab during the index period (September 2019-December 2021). Index date was the date of the first ixekizumab claim. All patients had continuous medical and pharmacy enrollment during the 12-month pre-index and follow-up periods. Descriptive statistics were used to assess patient demographics (index date); clinical characteristics (pre-index period); treatment patterns (12-month follow-up period); and HCRU (pre-index and 12-month follow-up periods).
The study included 177 patients (mean age 45.8 years; females 54.8%) with axSpA who initiated ixekizumab. Overall, 79.1% of patients reported prior biologic use; of these, 70.7% received tumor necrosis factor-alpha inhibitors (TNFi) and 49% received secukinumab. The mean (standard deviation [SD]) Charlson Comorbidity Index score was 1.1 (1.3) and ~ 27% of patients reported ≥2 comorbidities. The median (inter-quartile range [IQR]) number of ixekizumab prescription refills was 7 (4-11). The mean (SD) Proportion of Days Covered (PDC) for ixekizumab was 0.6 (0.3) and adherence (PDC ≥80%) was 34.5% (N = 61). Overall, 26.6% (N = 47) of patients switched to a non-index medication and 54.2% (N = 96) of patients discontinued ixekizumab. Among the patients who discontinued ixekizumab (N = 96), 19.8% (N = 19) restarted ixekizumab and 49.0% (N = 47) switched to a non-index medication. The median (IQR) ixekizumab persistence was 268 (120-366) days. Mean axSpA-related outpatient, inpatient, and emergency room visits were similar between the pre-index and follow-up periods. Treatment patterns were largely similar between biologic-experienced patients (N = 140; 79.1%) and the overall population.
Despite high comorbidity burden and majority of the patients being biologic-experienced, patients initiating ixekizumab for axSpA showed favorable persistence profiles during the 12-month follow-up period.
关于司库奇尤单抗在中轴型脊柱关节炎（axSpA）中应用的真实世界数据有限。我们使用美国默克集团（Merative L.P.）的MarketScan索赔数据库评估了axSpA患者的司库奇尤单抗治疗模式和医疗保健资源利用（HCRU）情况。
这项回顾性队列研究纳入了在索引期（2019年9月至2021年12月）开始使用司库奇尤单抗的成年axSpA患者。索引日期为首次司库奇尤单抗索赔日期。所有患者在索引前12个月和随访期内均持续进行医疗和药房登记。使用描述性统计来评估患者人口统计学特征（索引日期）、临床特征（索引前期）、治疗模式（12个月随访期）以及HCRU（索引前期和12个月随访期）。
该研究纳入了177例开始使用司库奇尤单抗的axSpA患者（平均年龄45.8岁；女性占54.8%）。总体而言，79.1%的患者报告曾使用过生物制剂；其中，70.7%接受过肿瘤坏死因子-α抑制剂（TNFi）治疗，49%接受过司库奇尤单抗治疗。查尔森合并症指数评分的平均值（标准差[SD]）为1.1（1.3），约27%的患者报告有≥2种合并症。司库奇尤单抗处方再填充的中位数（四分位间距[IQR]）为7（4 - 11）。司库奇尤单抗的平均（SD）覆盖天数比例（PDC）为0.6（0.3），依从性（PDC≥80%）为34.5%（N = 61）。总体而言，26.6%（N = 47）的患者换用了非索引药物，54.2%（N = 96）的患者停用了司库奇尤单抗。在停用司库奇尤单抗的患者中（N = 96），19.8%（N = 19）重新开始使用司库奇尤单抗，49.0%（N = 47）换用了非索引药物。司库奇尤单抗的中位（IQR）持续使用时间为268（120 - 至366）天。索引前期和随访期之间，与axSpA相关的门诊、住院和急诊就诊次数的平均值相似。有生物制剂使用经验的患者（N = 140；79.1%）和总体人群的治疗模式在很大程度上相似。
尽管合并症负担较高且大多数患者有生物制剂使用经验，但开始使用司库奇尤单抗治疗axSpA的患者在12个月随访期内显示出良好的持续用药情况。
