Background: Sickle cell disease (SCD) is an inherited blood disorder characterized by vaso-occlusive crises (VOCs). Crizanlizumab infusion was FDA approved in 2019 to reduce VOCs in patients with SCD ≥16 years old. There is little real-world evidence (RWE) regarding crizanlizumab use.

Objective: To describe real-world crizanlizumab utilization.

Methods: Using IQVIA’s US-based Longitudinal Pharmacy and Medical Claims Databases, patients with an SCD diagnosis between 01-November-2018 and 30-April-2021, ≥1 crizanlizumab claim (index date=first crizanlizumab claim) between 01-November-2019 and 31-January-2021, aged ≥16-years at index, ≥12-months of pre-index, and ≥6-months of post-index data were identified. Crizanlizumab treatment patterns were characterized by doses received, gap-days between doses (days between end of days-supply of one dose to the next administration), discontinuation (≥60-day gap), days on therapy prior to discontinuation, and restarts.

Results: In total 262 patients were included. Of these patients, 235(87%) received dose #2, 204(78%) received dose #3, and 174(66%) received ≥4 doses with a median(interquartile range [IQR]) of 125(43-180) days on therapy prior to discontinuation. In the 6-months post-index, 150(57%) patients discontinued crizanlizumab. Of those patients who discontinued crizanlizumab, 46(31%) restarted. Among the 112 patients that did not discontinue, the median(IQR) gap-days between doses 1&2=2(1-15) days, between doses 2&3=1(1-7) days, between doses 3&4=1(1-5) days, and between doses 4&5=1(1-6) days. At the end of the 6-months of follow-up, 88 patients (34% of all patients) appeared to be on crizanlizumab.

Conclusions: This RWE suggests that 66% of patients who receive crizanlizumab receive ≥4 doses within 6-months, patients receiving multiple doses appear to have a reduction in gap-days with each subsequent dose, and that of those who discontinue treatment, 31% restart crizanlizumab within 6-months post-index. Due to the nature of claims data, the reasons for discontinuation or gaps between doses are unknown. The impact of COVID-19 restrictions or other access barriers on crizanlizumab use is also unknown.