OBJECTIVES: To describe treatment and dosage patterns of oral corticosteroids (OCS) among patients with myasthenia gravis in the United States (US) and Sweden (SE).

METHODS: Adults with ≥ 2 primary diagnosis of MG (ICD-10: G70.0), with 1 diagnosis recorded by a neurologist and ≥ 1 record of OCS, were selected from the US MarketScan® (MSN) databases and Swedish National Registries (SNR), respectively. Index date was first OCS fill date within 12-month after MG diagnosis. Adherence was the sum of non-overlapped days’ supply of the index treatment divided by 365 days. Persistence was number of days from the index date to discontinuation date, allowing for gap of ≥90 days for discontinuation. Long-term OCS use was ≥3 months. Average daily dose (ADD) was calculated using days’ supply and considering prednisone equivalency conversion factor. High-dose OCS use was ADD ≥40 mg/day.

RESULTS: A total of 2,356 [mean (±SD) age 58.0 (±15.0) years; 50.8% were female] and 859 [mean (±SD) age 62.8 (±16.7) years; 50.3% were female] patients were identified from the MSN and SNR, respectively. Outcomes were similar in terms of average PDC (0.32 in US and 0.37 in SE), time to OCS discontinuation (5.4 months in SE and 5.8 months in US), and percentage of patients with long-term OCS use (61.8% in US and 58.7% in SE). Over 77% of patients with ADD ≥ 7.5mg/day were observed in both countries. Among patients with high-dose OCS regimens, a higher percentage of MG patients remained on treatment longer than 3 months in Sweden than in the US (51.6% vs 44.6%).

CONCLUSIONS: Study findings on OCS use using administrative databases from the US and Sweden, showed comparable results on persistence, discontinuation, OCS duration and high does use. Further studies are warranted to assess the impact of high-dose and long- term OCS use in this population.