Residual Burden in Adalimumab-Treated Patients with Hidradenitis Suppurativa
Author(s)
Kimball AB1, Tran T2, Friesen D3, Shang A4, Pansar I2, Oh T5, Aleshin MA6
1Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA, 2UCB Pharma, Brussels, Belgium, 3UCB Pharma, Slough, UK, 4UCB Pharma, Basel, Switzerland, 5UCB Pharma, Roswell, GA, USA, 6Stanford University School of Medicine, Stanford, CA, USA
Presentation Documents
OBJECTIVES: Until recently, adalimumab was the only approved biologic for patients with moderate to severe hidradenitis suppurativa (HS).1,2 However, some patients can be unresponsive to treatment, or lose response over time.1 Here, residual disease burden in adalimumab-treated HS patients was assessed by healthcare resource utilization (HCRU) changes after adalimumab initiation.
METHODS: This observational cohort study used Merative MarketScan® Commercial, Medicare, and Multi-State Medicaid claims databases. Patients with HS were new, adult adalimumab users (treatment started between September 2015 and December 2018), and had continuous insurance enrollment ≥1 year prior to adalimumab initiation (baseline). Patients were followed until adalimumab discontinuation, or end of enrollment/data availability. Overall and percentage difference in HCRU rate (claims/1,000 patient-years [kPY]) were reported for medication, hospitalization, and inpatient/outpatient care, minus baseline utilization rate.
RESULTS: Overall, 2,367 patients initiated adalimumab (mean age: 37 years; female: 77%; overweight/obese: 44%; Medicaid-insured: 30%); 67% stopped adalimumab before one year.
Across insurance types, largest increases in HCRU were seen for outpatient dermatology (404/kPY [39.2%]) and antidepressants (165/kPY [12.4%]), and largest decreases for systemic antibiotics (−978/kPY [1.8%]) and opioid analgesics (−258/kPY [2.3%]). For some resources, HCRU rates differed between insurance types; notably, neuropathic pain agents increased in Medicaid- versus Commercial/Medicare-insured patients (237/kPY [12.0%] versus 1.2/kPY [2.5%]). Longer duration of adalimumab use resulted in larger HCRU decreases, notably for systemic antibiotics, non-opioid analgesics, and hospitalizations. HS-related outpatient claims decreased by −529/kPY (30.9%) and −851/kPY (29.5%) with ≥1 and ≥2 years of treatment.CONCLUSIONS: HS-related HCRU changes during adalimumab treatment were small; reductions in some resource utilizations were only shown after ≥1 year, however many patients discontinued treatment before this timepoint. Alternative options are needed to address the residual disease burden in adalimumab-treated patients with HS.
1. Markota Čagalj A. Int J Mol Sci 2022;23:3753; 2. Kimball AB. N Engl J Med 2016;375:422-34.Conference/Value in Health Info
Value in Health, Volume 27, Issue 6, S1 (June 2024)
Code
EE405
Topic
Economic Evaluation
Disease
Biologics & Biosimilars, Sensory System Disorders (Ear, Eye, Dental, Skin)