Treatment pattern and changes in oral glucocorticoid dose after tocilizumab treatment in patients with adult Still's disease: An analysis of a Japanese claims database

Author:

Kaneko Yuko1ORCID,Kameda Hideto2ORCID,Ikeda Kei34ORCID,Yamashita Katsuhisa5,Ozaki Ryoto5ORCID,Tanaka Yoshiya6ORCID

Affiliation:

1. Division of Rheumatology, Department of Internal Medicine Keio University School of Medicine Tokyo Japan

2. Division of Rheumatology, Department of Internal Medicine Toho University Ohashi Medical Center Tokyo Japan

3. Department of Allergy and Clinical Immunology Chiba University Hospital Chiba Japan

4. Department of Rheumatology Dokkyo Medical University Tochigi Japan

5. Chugai Pharmaceutical Co., Ltd. Tokyo Japan

6. The First Department of Internal Medicine, School of Medicine University of Occupational and Environmental Health Kitakyushu Japan

Abstract

AbstractAimIntravenous tocilizumab (TCZ‐IV) was approved for the treatment of adult Still's disease (ASD) in Japan in May 2019 based on its efficacy and safety in a phase III randomized controlled trial. This study determined treatment patterns in patients with ASD and assessed oral glucocorticoid (GC) dose changes after TCZ‐IV administration in Japanese clinical practice.MethodsPatients in the Medical Data Vision database aged 16 years or older with one or more of International Classification of Diseases, 10th revision codes M061 (ASD) or M082 (systemic juvenile idiopathic arthritis) during January 2017–March 2021 (cohort 1) and those initiating TCZ‐IV during May 2019–March 2021 (cohort 2) were included.ResultsIn cohort 1, the proportion of patients who were prescribed interleukin‐6 inhibitors (mainly TCZ‐IV) increased from 10.8% (January–April 2019 [before TCZ‐IV approval]; n = 2002) to 18.3% (January–March 2021 [after TCZ‐IV approval]; n = 2008). In cohort 2 (n = 193), 84.5% of patients were on oral GCs (≤5 mg/day: 23.8%) at index date (initial TCZ‐IV prescription date); 46/70 (65.7%) were on oral GC at 5 mg/day or higher 12 months after TCZ‐IV treatment (primary outcome). After 12 months of treatment, the TCZ‐IV retention rate was 73.6% and the TCZ‐IV administration interval was every 4 weeks and every 2 weeks in 31.9% and 27.7% of patients, respectively.ConclusionThe use of interleukin‐6 inhibitors increased by 7.5% points in Japanese patients with ASD ~2 years after TCZ‐IV approval, suggesting that an unmet medical need existed. This study suggests the potential GC‐sparing effect of TCZ‐IV in patients with ASD in clinical practice.

Funder

Chugai Pharmaceutical

Publisher

Wiley

Subject

Rheumatology

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