Background Sjogren's syndrome (SS) is a systemic autoimmune disease associated with lymphocytic infiltration of the exocrine glands, often accompanied by widespread pain and fatigue. There is no approved disease-modifying agent for SS and little information on SS treatment practices .
Objectives To better understand the patient population and real-world standard of care for SS, we conducted a retrospective study using the MarketScan Commercial Claims database.
Methods We identified 11,385 patients ≥18 years old with ≥1 inpatient or ≥2 outpatient SS diagnosis codes (ICD-9-CM code: 710.2) from Jan. 1, 2006 to Dec. 31, 2011. Patients with continuous pharmaceutical/medical benefits for 12 months pre- and post-index were selected to obtain patient characteristics, drug and resource utilization, and medical costs.
Results 90% of patients were female (mean age 55 years); physician specialties associated with initial SS diagnosis were rheumatology (39.0%), internal medicine (14.2%), family practice/medical doctor (13.9%), and ophthalmology (6.1%). Common comorbidities among SS patients were: hypertension (37.1%), osteoarthritis (30.9%), hyperlipidemia (29.6%), and mental disorders (25.0%). Approximately 54% of patients had another autoimmune condition; most commonly: rheumatoid arthritis (17.5%), systemic lupus erythematosus (14.5%), and unspecified inflammatory polyarthropathy (6.4%). Anti-rheumatic medications prescribed during the 12 months post-diagnosis were: low dose steroid ([<20mg/d prednisone equivalent], 21.3%), hydroxychloroquine (21.0%), topical cyclosporine (15.0%), and cevimeline (14.9%). Approximately 6.1% of patients were on a biologic, 37.3% were on a synthetic immunomodulator, and 7.1% were on high dose steroids (≥20mg/d prednisone equivalent). In patients without concurrent autoimmune diagnoses 0.3% were on a biologic, 19.3% were on a synthetic immunomodulator, and 5.5% were on high dose steroids. Of note, 15.1% of patients received no anti-rheumatic medications. In the 12 months post-SS diagnosis, total medical resource utilization was 1.2 times higher and total medical costs were 1.4 higher, compared to pre-diagnosis.
Conclusions This retrospective analysis of a large group of real-world SS patients provides important insights into treatment practices and medical resource utilization. More than half of the patients with SS were diagnosed by a non-rheumatologist. Compared to pre-diagnosis, greater health care costs were incurred after SS diagnosis. Pharmacologic management of SS consisted primarily of low-grade immunomodulation and symptomatic treatments. Systemic disease-modifying therapies were used in a minority of SS patients and most of these patients had other autoimmune diagnoses, suggesting there may be a large unmet need in patients with SS.
Brito-Zeron P, et al. Primary Sjogren Syndrome: an update on current pharmacotherapy options and future directions. Exp Opin on Pharmacother 2013;14(3):279-89.
Disclosure of Interest J. Birt Shareholder of: Eli Lilly & Company, Employee of: Eli Lilly & Company, Y. Tan Shareholder of: Eli Lilly & Company, Employee of: Eli Lilly & Company, C.-Y. Lin Shareholder of: Eli Lilly & Company, Employee of: Eli Lilly & Company, Y. Wang Shareholder of: Inventiv Health, Employee of: Inventiv Health, N. Mozaffarian Shareholder of: Eli Lilly & Company, Employee of: Eli Lilly & Company
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.