Long-term oral glucocorticoid use is associated with complications, healthcare resource utilization, and costs among patients with dermatomyositis or polymyositis

Le résumé fourni par la source

INTRODUCTION/OBJECTIVE: Oral glucocorticoids (OGC) are conventionally used as first-line treatment for dermatomyositis (DM) and polymyositis (PM). This study evaluated clinical and economic outcomes associated with long-term (LT) OGC use in DM/PM. METHODS: Adults with ≥ 2 medical claims of DM/PM 30‒365 days apart from January 1, 2016, to December 31, 2022, and ≥ 1 diagnosis code of a physician specialty of interest were selected from the MarketScan Commercial and Medicare Supplemental databases. Patients should have ≥ 1 OGC pharmacy claim (i.e., date of first claim defined as index date) on or after the diagnosis date, ≥ 12 months pre- and post-index continuous enrollment, and no diagnosis of inclusion body myositis during the study. The LT group included patients with continuous OGC use for ≥ 3 consecutive months within the 12-month post-index period, whereas short-term (ST) users included those with < 3 consecutive months of OGC use. RESULTS: Two thousand two-hundred eighty patients were included (LT, 1313 [57.6%]; ST, 967 [42.4%]). Compared with ST, LT OGC patients had significantly higher incidences of OGC-related complications, such as heart failure (adjusted odds ratio [aOR], 1.8; 95% CI, 1.3‒2.7) and osteoporosis (aOR, 1.9; 95% CI, 1.4‒2.6), after covariate adjustment. LT users had increased odds for both all-cause (aOR, 1.7; 95% CI, 1.3‒2.2) and disease-related inpatient admission (aOR, 3.8; 95% CI, 2.3‒6.2) versus ST users. Higher adjusted average annual all-cause (by US $30,555; p < 0.01) and disease-related costs (by US $21,311; p < 0.01) were incurred by LT versus ST users. CONCLUSIONS: DM/PM patients with LT OGC use had higher rates of associated medical conditions and higher healthcare resource utilization and costs than ST users. Key points • Long-term use of oral glucocorticoids (OGC) in patients with dermatomyositis (DM) and polymyositis (PM) is associated with increased risk of complications, and there is limited real-world evidence on the association of long-term use with clinical and economic outcomes. • This real-world claims-based study demonstrated that long-term OGC use in patients with DM/PM leads to higher rates of complications, advanced treatment use and healthcare resource utilization, and higher costs compared with short-term OGC use. • These findings highlight the limitations of OGC as a therapeutic tool and further support an unmet medical need for new treatment options among patients with DM/PM. • Disease management with novel treatments that have an advantageous safety profile and can be utilized any time throughout the disease course may provide safer, more efficacious alternatives to OGC.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.