V. Perrone, Silvia Sabatino, Arianna Avitabile, Melania Dovizio, Melania Leogrande, Luca Degli Esposti
{"title":"真实世界的证据:意大利的斑秃患者。","authors":"V. Perrone, Silvia Sabatino, Arianna Avitabile, Melania Dovizio, Melania Leogrande, Luca Degli Esposti","doi":"10.23736/S2784-8671.24.07785-5","DOIUrl":null,"url":null,"abstract":"BACKGROUND\nThis real-world analysis aimed at characterizing patients hospitalized for alopecia areata (AA) in Italy, focusing on comorbidities, treatment patterns and the economic burden for disease management.\n\n\nMETHODS\nAdministrative databases of healthcare entities covering 8.9 million residents were retrospectively browsed to include patients of all ages with hospitalization discharge diagnosis for AA from 2010 to 2020. The population was characterized during the year before the first AA-related hospitalization (index-date) and followed-up for all the available successive period. AA drug prescriptions and treatment discontinuation were analyzed during follow-up. Healthcare costs were also examined.\n\n\nRESULTS\nAmong 252 patients with AA (mean age 32.1 years, 40.9% males), the most common comorbidities were thyroid disease (22.2%) and hypertension (21.8%), consistent with literature; only 44.4% (112/252) received therapy for AA, more frequently with prednisone, triamcinolone and clobetasol. Treatment discontinuation (no prescriptions during the last trimester) was observed in 86% and 88% of patients, respectively at 12 and 24-month after therapy initiation. Overall healthcare costs were 1715€ per patient (rising to 2143€ in the presence of comorbidities), mostly driven by hospitalization and drugs expenses.\n\n\nCONCLUSIONS\nThis first real-world description of hospitalized AA patients in Italy confirmed the youth and female predominance of this population, in line with international data. The large use of corticosteroids over other systemic therapies followed the Italian guidelines, but the high discontinuation rates suggest an unmet need for further treatment options. Lastly, the analysis of healthcare expenses indicated that hospitalizations and drugs were the most impactive cost items.","PeriodicalId":14526,"journal":{"name":"Italian Journal of Dermatology and Venereology","volume":null,"pages":null},"PeriodicalIF":1.8000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Real world evidence: patients with alopecia areata in Italy.\",\"authors\":\"V. 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The large use of corticosteroids over other systemic therapies followed the Italian guidelines, but the high discontinuation rates suggest an unmet need for further treatment options. 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引用次数: 0
摘要
方法回顾性地浏览了覆盖 890 万居民的医疗机构的行政数据库,其中包括 2010 年至 2020 年期间出院诊断为 AA 的各年龄段患者。研究人员对首次与 AA 相关的住院治疗前一年(索引日期)的人群进行了特征描述,并对所有可用的连续时期进行了随访。对随访期间的 AA 药物处方和治疗中断情况进行了分析。结果在 252 名 AA 患者(平均年龄 32.1 岁,男性占 40.9%)中,最常见的合并症是甲状腺疾病(22.2%)和高血压(21.8%),这与文献报道一致;只有 44.4%(112/252)的患者接受了 AA 治疗,其中更多的是泼尼松、曲安奈德和氯倍他索。在开始治疗后的 12 个月和 24 个月中,分别有 86% 和 88% 的患者停止了治疗(在最后三个月中没有处方)。每名患者的总体医疗费用为 1715 欧元(合并症患者的医疗费用增至 2143 欧元),主要由住院和药物费用造成。根据意大利指南,患者大量使用皮质类固醇而非其他系统疗法,但高停药率表明患者对进一步治疗方案的需求尚未得到满足。最后,对医疗费用的分析表明,住院和药物是影响最大的费用项目。
Real world evidence: patients with alopecia areata in Italy.
BACKGROUND
This real-world analysis aimed at characterizing patients hospitalized for alopecia areata (AA) in Italy, focusing on comorbidities, treatment patterns and the economic burden for disease management.
METHODS
Administrative databases of healthcare entities covering 8.9 million residents were retrospectively browsed to include patients of all ages with hospitalization discharge diagnosis for AA from 2010 to 2020. The population was characterized during the year before the first AA-related hospitalization (index-date) and followed-up for all the available successive period. AA drug prescriptions and treatment discontinuation were analyzed during follow-up. Healthcare costs were also examined.
RESULTS
Among 252 patients with AA (mean age 32.1 years, 40.9% males), the most common comorbidities were thyroid disease (22.2%) and hypertension (21.8%), consistent with literature; only 44.4% (112/252) received therapy for AA, more frequently with prednisone, triamcinolone and clobetasol. Treatment discontinuation (no prescriptions during the last trimester) was observed in 86% and 88% of patients, respectively at 12 and 24-month after therapy initiation. Overall healthcare costs were 1715€ per patient (rising to 2143€ in the presence of comorbidities), mostly driven by hospitalization and drugs expenses.
CONCLUSIONS
This first real-world description of hospitalized AA patients in Italy confirmed the youth and female predominance of this population, in line with international data. The large use of corticosteroids over other systemic therapies followed the Italian guidelines, but the high discontinuation rates suggest an unmet need for further treatment options. Lastly, the analysis of healthcare expenses indicated that hospitalizations and drugs were the most impactive cost items.