Disease-modifying drug initiation patterns in commercially insured multiple sclerosis patients: a retrospective cohort study.
Disease-modifying drug initiation patterns in commercially insured multiple sclerosis patients: a retrospective cohort study.
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DOI：
10.1186/1471-2377-11-122
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发表时间：
2011-10-06
期刊：
影响因子：
2.6
通讯作者：
Kahler K
中科院分区：
文献类型：
--
作者：
Margolis JM;Fowler R;Johnson BH;Kassed CA;Kahler K
本研究的目的是比较接受疾病缓解药物（DMD）治疗与未接受DMD治疗的商业管理护理人群中新诊断多发性硬化（MS）患者的人口统计学、临床特征和治疗模式。一项使用美国行政医疗保健索赔的回顾性队列研究确定了2001-2007年期间新诊断为MS（使用ICD-9-CM 340之前12个月无既往MS诊断）且≥ 18岁的个体，以根据人口统计学、临床特征和索引前1年和索引后至少1年的药物治疗对其进行表征。索引日期是研究期间发生的首次MS诊断。通过ICD-9-CM代码识别而不是通过实际病历审查对受试者进行随访。进行多变量分析以调整混杂变量。患者在索引诊断后平均随访35.7 ± 17.5个月。43%（n = 4，462）的事件患者在索引后期间接受了至少一种DMD的治疗。接受治疗的患者主要是18-44岁的年轻患者，DMD治疗平均在索引诊断后5.3 ± 9.1个月开始。一旦开始治疗，27.7%的患者在平均17.6 ± 14.6个月后停止DMD治疗，16.5%的患者治疗间隔超过60天。在这一商业管理的护理人群中，近60%的新诊断MS患者仍未接受治疗，而超过四分之一的治疗患者停止治疗，六分之一的患者尽管存在疾病进展或治疗前疾病活动恢复的风险，但仍出现治疗间隙。
The goal of this research was to compare the demographics, clinical characteristics and treatment patterns for newly diagnosed multiple sclerosis (MS) patients in a commercial managed care population who received disease-modifying drug (DMD) therapy versus those not receiving DMD therapy. A retrospective cohort study using US administrative healthcare claims identified individuals newly diagnosed with MS (no prior MS diagnosis 12 months prior using ICD-9-CM 340) and ≥ 18 years old during 2001-2007 to characterize them based on demographics, clinical characteristics, and pharmacologic therapy for one year prior to and a minimum of one year post-index. The index date was the first MS diagnosis occurring in the study period. Follow-up of subjects was done by ICD-9-CM code identification and not by actual chart review. Multivariate analyses were conducted to adjust for confounding variables. Patients were followed for an average of 35.7 ± 17.5 months after their index diagnosis. Forty-three percent (n = 4,462) of incident patients received treatment with at least one of the DMDs during the post-index period. Treated patients were primarily in the younger age categories of 18-44 years of age, with DMD therapy initiated an average of 5.3 ± 9.1 months after the index diagnosis. Once treatment was initiated, 27.7% discontinued DMD therapy after an average of 17.6 ± 14.6 months, and 16.5% had treatment gaps in excess of 60 days. Nearly 60% of newly-diagnosed MS patients in this commercial managed care population remained untreated while over a quarter of treated patients stopped therapy and one-sixth experienced treatment gaps despite the risk of disease progression or a return of pre-treatment disease activity.
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影响因子：
5.8
作者：
Marrie, R. A.;Horwitz, R.;Vollmer, T.
通讯作者：
Vollmer, T.
影响因子：
9.9
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Marrie, R. A.;Horwitz, R.;Vollmer, T.
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11.2
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作者：
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14.5
作者：
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