scholarly journals Trends in diagnostic prevalence and treatment patterns of male and female ankylosing spondylitis patients in the United States, 2006–2016

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Jessica Walsh ◽  
Theresa Hunter ◽  
Krista Schroeder ◽  
David Sandoval ◽  
Rebecca Bolce
Keyword(s):  
United States ◽  
Ankylosing Spondylitis ◽  
The United States ◽  
Epidemiological Studies ◽  
Treatment Patterns ◽  
Opioid Use ◽  
Biologic Dmards ◽  
Male And Female ◽  
Pharmacy Claims ◽  
Diagnosis Codes

Abstract Background There has been much variation between epidemiological studies that report the prevalence of ankylosing spondylitis (AS). This study aimed to analyze the diagnostic prevalence rates and treatment patterns of male and female AS patients in the United States adult insured population from 2006 to 2016. Methods Trends in AS prevalence were calculated for the 11-year period covering January 1, 2006 to December 31, 2016. Adult (18+ years old) AS patients were included in this retrospective analysis of medical and pharmacy claims data from the IBM Marketscan Commercial, Medicaid and Medicare-Supplemental Claims database. Prevalence was determined as having ≥1 AS diagnostic codes (ICD-9:720.0; ICD-10:M45.x). Trends in treatment patterns were also analyzed and stratified by gender. Results The AS prevalence increased from 0.04 to 0.09% from 2006 to 2016. The mean age between 2006 and 2016 ranged from 49.52–50.00 years. In 2006, approximately 40% of AS patients were female, while in 2016 over 47% of AS patients were female. Rates of use of TNF inhibitors and oral glucocorticoids increased, while NSAIDs and non-biologic DMARDs (sulfasalazine & methotrexate) rates decreased. Opioid use rates were stable. In 2016, males were more likely to be prescribed biologics, while females were more likely to be prescribed methotrexate, sulfasalazine, NSAIDs, muscle relaxants, anticonvulsants, opioids, and glucocorticoids. Conclusions The prevalence of AS diagnosis codes more than doubled between 2006 and 2016, but the very low prevalence suggests that AS continues to be underdiagnosed and under-addressed in routine clinical practice. Despite the increase in female AS patients, females were less likely to be prescribed biologics compared to male AS patients.

Treatment patterns by lines of therapy in metastatic breast cancer: Evidence from a large insured population in the United States.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 116-116
Author(s):  
Saurabh Ray ◽  
Vijayveer Bonthapally ◽  
Donna McMorrow ◽  
Machaon Bonafede ◽  
Pamela Landsman-Blumberg
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Metastatic Breast Cancer ◽  
Biologic Therapy ◽  
Metastatic Breast ◽  
The United States ◽  
Treatment Patterns ◽  
Adult Women ◽  
Pharmacy Claims ◽  
Number Of Patients

116 Background: Metastatic breast cancer (mBC) guidelines contain multiple lines of treatment (LOTs) and regimen options, however little data on treatment patterns is available from real world clinical practice. This study describes patterns of chemo and biologic therapy use by LOT observed within a large U.S. insured population. Methods: Adult women with newly diagnosed mBC and starting anti-neoplastic treatment were identified in the 2005-2009 MarketScan Database which contains medical, pharmacy claims of > 40 million enrollees insured with >100 health plans across the United States. The index date was the first prescription fill or administration of anti-neoplastic treatment following metastatic diagnosis. A 90-day gap in treatment or initiation of a new regimen defined the end of a LOT. Patient demographics and clinical characteristics were measured at index. Descriptive analyses included the distribution of patients, use of chemo and biologic therapies and their therapy duration, across the first 4 LOTs observed. Results: Of 7,767 patients identified (mean (SD) age=58.2 (11.9) years), ≥50% received a subsequent LOT across the 4 LOTs (2nd LOT n=4,077, 3rd LOT n=2,033, 4th LOT n=1,059). Bone (44%) was the major metastatic site at diagnosis. The days on therapy (mean, SD, median) varied across LOTs: (162.7, 176.9, 108.0) in 1st, (147.5, 146.7, 99.0) in 2nd, (139.9, 131.1, 99.0) in 3rd, and (130.9, 123.4, 94.0) in 4th LOT. The most common backbone chemotherapies were: paclitaxel (26%), capecitabine (22%), docetaxel (22%) in 1st; paclitaxel (28%), capecitabine (18%), gemcitabine (16%) in 2nd; paclitaxel (22%), gemcitabine (19%), capecitabine (16%) in 3rd, and gemcitabine (19%), paclitaxel (18%), capecitabine (16%) in 4th LOT. Trastuzumab was the most frequently used biologic across all 4 lines (20%, 19%, 19%, 19% in 1st to 4th LOT respectively) followed by bevacizumab (20%, 19%, 19%, 19% in 1st to 4th LOT respectively). Lapatinib was used in 3rd (6%) and 4thLOTs (8%) only. Conclusions: Frequency and duration of chemo and biologic therapy use varied by LOT. The most frequently used agents across the 4 LOTs were paclitaxel (chemo backbones) and trastuzumab (biologics). Number of patients halved with each subsequent LOT.

scholarly journals Su1597 – Increasing Inpatient Burden of Constipation and Its Relation to Opioid Use: National Trends in the United States

2019 ◽  
Vol 156 (6) ◽  
pp. S-577
Author(s):  
Eula P. Tetangco ◽  
Supannee Rassameehiran ◽  
George Tan ◽  
Humberto Sifuentes
Keyword(s):  
United States ◽  
The United States ◽  
Opioid Use ◽  
National Trends

scholarly journals Gender disparities in opioid treatment progress in methadone versus counseling

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Erick Guerrero ◽  
Hortensia Amaro ◽  
Yinfei Kong ◽  
Tenie Khachikian ◽  
Jeanne C. Marsh
Keyword(s):  
United States ◽  
Treatment Outcomes ◽  
Treatment Plan ◽  
Dropout Rate ◽  
The United States ◽  
Gender Disparities ◽  
Opioid Use ◽  
Lower Odds ◽  
Male Clients ◽  
Multi Level

Abstract Background In the United States, the high dropout rate (75%) in opioid use disorder (OUD) treatment among women and racial/ethnic minorities calls for understanding factors that contribute to making progress in treatment. Whereas counseling and medication for OUD (MOUD, e.g. methadone, buprenorphine, naltrexone) is considered the gold standard of care in substance use disorder (SUD) treatment, many individuals with OUD receive either counseling or methadone-only services. This study evaluates gender disparities in treatment plan progress in methadone- compared to counseling-based programs in one of the largest SUD treatment systems in the United States. Methods Multi-year and multi-level (treatment program and client-level) data were analyzed using the Integrated Substance Abuse Treatment to Eliminate Disparities (iSATed) dataset collected in Los Angeles County, California. The sample consisted of 4 waves: 2011 (66 SUD programs, 1035 clients), 2013 (77 SUD programs, 3686 clients), 2015 (75 SUD programs, 4626 clients), and 2017 (69 SUD programs, 4106 clients). We conducted two multi-level negative binomial regressions, one per each outcome (1) making progress towards completing treatment plan, and (2) completing treatment plan. We included outpatient clients discharged on each of the years of the study (over 95% of all clients) and accounted for demographics, wave, homelessness and prior treatment episodes, as well as clients clustered within programs. Results We detected gender differences in two treatment outcomes (progress and completion) considering two outpatient program service types (MOUD-methadone vs. counseling). Clients who received methadone vs. counseling had lower odds of completing their treatment plan (OR = 0.366; 95% CI = 0.163, 0.821). Female clients receiving methadone had lower odds of both making progress (OR = 0.668; 95% CI = 0.481, 0.929) and completing their treatment plan (OR = 0.666; 95% CI = 0.485, 0.916) compared to male clients and receiving counseling. Latina clients had lower odds of completing their treatment plan (OR = 0.617; 95% CI = 0.408, 0.934) compared with non-Latina clients. Conclusions Clients receiving methadone, the most common and highly effective MOUD in reducing opioid use, were less likely to make progress towards or complete their treatment plan than those receiving counseling. Women, and in particular those identified as Latinas, were least likely to benefit from methadone-based programs. These findings have implications for health policy and program design that consider the need for comprehensive and culturally responsive services in methadone-based programs to improve outpatient treatment outcomes among women.

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