Princic Nicole, Evans Kristin A, Shah Chintal H, Sing Krystal, Juethner Salomé, Schultz Bob G
Merative, Ann Arbor, MI, USA.
University of Maryland, Baltimore, MD, USA.
Drugs Real World Outcomes. 2025 Mar;12(1):17-24. doi: 10.1007/s40801-024-00470-x. Epub 2025 Jan 29.
Lanadelumab is the only long-term prophylaxis indicated for reduced administration frequency in patients with hereditary angioedema who have been well controlled for > 6 months. Understanding the characteristics of patients who reduce administration frequency will help identify populations where frequency modifications may be appropriate.
We aimed to describe characteristics of patients who did and did not reduce lanadelumab administration frequency to inform real-world dosing regimens, and characteristics indicative of sustained frequency reduction.
A retrospective observational study using healthcare insurance data in the USA from the Merative™ MarketScan Commercial and Medicare Databases identified patients persistent on lanadelumab for ≥ 18 months. Reduced administration frequency was defined as a ≥ 25% decrease in lanadelumab costs during months 7-12 or 13-18 versus 0-6. Hereditary angioedema attack triggers/symptoms and hereditary angioedema-related healthcare encounters, treatment, and costs were assessed.
Of 54 identified patients, 25 reduced administration frequency. Two patients returned to initial dosing frequency during months 13-18 after reducing during months 7-12. Patients who reduced administration frequency experienced fewer hereditary angioedema attack triggers/symptoms before lanadelumab initiation (baseline) and during months 0-6 than those who did not; they also had a lower mean number of hereditary angioedema-related inpatient admissions, emergency room visits, and outpatient visits during baseline, had fewer claims for acute treatment (60.0% vs 65.5%) and prior long-term prophylaxis (20.0% vs 27.6%), and had lower mean hereditary angioedema treatment costs at baseline ($139,520 vs $233,815) than those who did not.
This real-world analysis suggests that patients with less frequent hereditary angioedema-related healthcare encounters, lower disease activity, and lower costs within 6 months before lanadelumab initiation are more likely to achieve reduced dosing frequency.
Lanadelumab是唯一一种被批准用于遗传性血管性水肿患者的长期预防药物，可减少给药频率，且这些患者已得到良好控制超过6个月。了解减少给药频率的患者特征将有助于确定哪些人群可能适合调整给药频率。
我们旨在描述减少和未减少Lanadelumab给药频率的患者特征，以指导实际给药方案，并确定持续减少给药频率的特征。
一项回顾性观察研究，使用美国Merative™ MarketScan商业和医疗保险数据库中的医疗保险数据，确定持续使用Lanadelumab≥18个月的患者。给药频率降低定义为第7 - 12个月或第13 - 18个月与第0 - 6个月相比，Lanadelumab成本降低≥25%。评估遗传性血管性水肿发作诱因/症状以及与遗传性血管性水肿相关的医疗就诊、治疗和费用。
在54例确诊患者中，25例降低了给药频率。2例患者在第7 - 12个月降低给药频率后，在第13 - 18个月恢复到初始给药频率。与未降低给药频率的患者相比，降低给药频率的患者在开始使用Lanadelumab之前（基线）和第0 - 6个月期间经历的遗传性血管性水肿发作诱因/症状更少；他们在基线时遗传性血管性水肿相关的住院次数、急诊室就诊次数和门诊就诊次数的平均数也更低，急性治疗索赔（60.0%对65.5%）和先前长期预防索赔（20.0%对27.6%）更少，并且基线时遗传性血管性水肿治疗平均成本（139,520美元对233,815美元）也低于未降低给药频率的患者。
这项真实世界分析表明，在开始使用Lanadelumab前6个月内，遗传性血管性水肿相关医疗就诊频率较低、疾病活动度较低且成本较低的患者更有可能实现给药频率降低。
