Real-world patterns of pegloticase use for treatment of gout: descriptive multidatabase cohort study.
Real-world patterns of pegloticase use for treatment of gout: descriptive multidatabase cohort study.
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DOI：
10.1136/bmjopen-2020-041167
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发表时间：
2020-12-07
期刊：
影响因子：
2.9
通讯作者：
Kim SC
中科院分区：
文献类型：
--
作者：
Chen SK;Liu J;Kim SC
Pegloticase用于严重难治性痛风或对其他降尿酸治疗不耐受的病例。我们试图评价pegloticase在美国的使用模式和安全性结局的发生率。我们使用两个美国商业保险索赔数据库（2010-2018）的数据进行了回顾性描述性研究。我们确定了在开始pegloticase治疗前365天基线期内具有≥1个痛风诊断代码的pegloticase新启动者。我们测量了pegloticase输注的次数和持续时间。我们评估了在接受聚乙二醇替加酶治疗期间发生速发过敏反应或类速发过敏反应、心血管事件（包括心肌梗死或卒中）和因心力衰竭住院（新发或加重）的风险。在290万例诊断≥1次痛风的患者中，我们仅确定了483例（Optum中179例，MarketScan中304例）pegloticase启动者。平均年龄和女性百分比为55.6岁，MarketScan为10.9%，Optum为60.6岁和17.3%。85%的患者患有高血压，38%患有糖尿病，46%患有慢性肾病，21%患有心力衰竭。中位输注次数为4次，治疗持续时间为3个月。在pegloticase的平均0.5年随访时间内，发生了3例（0.6%）速发过敏反应、7例（1.4%）复合心血管事件、31例（6.4%）心力衰竭住院和3例（0.6%）死亡。Pegloticase很少用于痛风，Pegloticase治疗的中位持续时间为3个月。在这项基于索赔的研究中，几乎没有速发过敏反应事件，而心力衰竭住院很常见。
Pegloticase is used in severe refractory gout or in cases of intolerance to other urate-lowering therapies. We sought to evaluate the patterns of pegloticase use in the USA and the incidence of safety outcomes. We conducted a retrospective descriptive study using data from two US commercial insurance claims databases (2010–2018). We identified new initiators of pegloticase with ≥1 gout diagnosis code in the 365-day baseline period prior to pegloticase initiation. We measured the number and duration of pegloticase infusions. We assessed the risk of anaphylaxis or anaphylactoid reactions, cardiovascular events, including myocardial infarction or stroke, and hospitalisation for heart failure (new onset or exacerbations) while undergoing pegloticase therapy. Among 2.9 million patients with ≥1 diagnosis of gout, we identified only 483 (179 in Optum and 304 in MarketScan) pegloticase initiators. The mean age and % female was 55.6 years, 10.9% for MarketScan and 60.6 years and 17.3% for Optum. Hypertension was present in up to 85%, diabetes mellitus in 38%, chronic kidney disease in 46% and heart failure in 21% of the patients. The median number of infusions was four and the duration of therapy was 3 months. During the mean 0.5-year follow-up time on pegloticase, there were 3 (0.6%) anaphylaxis, 7 (1.4%) composite cardiovascular, 31 (6.4%) heart failure hospitalisations and 3 (0.6%) deaths. Pegloticase is rarely used in gout, and the median duration of pegloticase therapy was 3 months. There were few anaphylaxis events captured in this claims-based study, while heart failure hospitalisations were common.
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影响因子：
3.9
作者：
Becker, Michael A.;Schumacher, H. Ralph;Sundy, John S.
通讯作者：
Sundy, John S.
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通讯作者：
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