Real-World Treatment Patterns in Chronic Spontaneous Urticaria in the United States

Author(s)

Balp MM1, Geissbühler Y1, Mcconnon A2, Gomme J2, Mckenna SJ2, Kohli R3, Soong W4
1Novartis Pharma AG, Basel, BS, Switzerland, 2Novartis, Dublin, Ireland, 3Novartis Healthcare Pvt. Ltd., Hyderabad, AP, India, 4AllerVie Health-Alabama Allergy & Asthma Center, Birmingham, AL, USA

OBJECTIVES:

Treatment of chronic spontaneous urticaria (CSU) in the US is a stepwise approach recommended by local guidelines. First line: non-sedating H1-antihistamines (ns-H1AH); 2nd line & 3rd line: increased licensed dose ns-H1AH or change of H1AH or add H2-antihistamines (H2AH) or leukotriene inhibitor (LTRA) or sedating H1AH or doxepin; 4th line: add omalizumab or cyclosporine. Rescue medication with short-course oral corticosteroids (OCS), in case of exacerbations. The objective of the study was to assess real-world treatment patterns in adult patients with CSU.

METHODS:

Adult patients were identified in the Optum® Clinformatics Data Mart Claims based on ≥2 relevant ICD-9 and/or 10 codes ≥30 days apart during the study identification period (01-Jan-2012 to 31-Dec-2018) with index date the first relevant ICD code and data available for at least 12 months pre- and post-index. Prescription fills were extracted from claims in the 1-year post-index date and reported.

RESULTS:

Of 40,041 patients included in the analysis, 34.8% did not receive any CSU treatment during year one. For the 65.2% of treated patients following medications were prescribed: OCS (47.0%), LTRAs (19.4%), H2AH (11.9%), ns‑H1AH (10.2%), sedating H1AH (6.1%), doxepin (5.3%), other immunosuppressive agents (4.2%), omalizumab (3.2%), and cyclosporin (1.9%). Median time (days) from diagnosis to first prescription varied: OCS (1 day), H2AH (6), ns‑H1AH (14), LTRAs (22), doxepin (42), other immunosuppressive agents (57.5), cyclosporine (84), omalizumab (109.5), and sedating H1AH (144.5). Among patients who received CSU treatment, majority received a single regimen (45.2%), while 22.3% and 32.6% received 2 or ≥ 3 treatment regimens, respectively in the first year after diagnosis.

CONCLUSIONS:

Real-world treatment patterns do not follow clinical guidelines with one-half of patients being initiated directly on OCS, few on ns‑H1AH. Various treatments are prescribed with more than half receiving ≥ 2 regimens. Management of CSU in practice should be reconsidered.

Conference/Value in Health Info

2022-11, ISPOR Europe 2022, Vienna, Austria

Value in Health, Volume 25, Issue 12S (December 2022)

Code

RWD83

Topic

Real World Data & Information Systems

Topic Subcategory

Health & Insurance Records Systems

Disease

SDC: Sensory System Disorders (Ear, Eye, Dental, Skin)

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