A Descriptive Cohort Study of Drug Utilization Patterns Among Patients Hospitalized With Coronavirus Disease 2019 in the United States, January 2021-February 2022.
COVID-19
Janus kinase inhibitors
drug utilization
interleukin-6 inhibitors
Journal
Open forum infectious diseases
ISSN: 2328-8957
Titre abrégé: Open Forum Infect Dis
Pays: United States
ID NLM: 101637045
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
received:
17
01
2023
accepted:
06
07
2023
pmc-release:
10
07
2024
medline:
27
7
2023
pubmed:
27
7
2023
entrez:
27
7
2023
Statut:
epublish
Résumé
There is a dearth of drug utilization studies for coronavirus disease 2019 (COVID-19) treatments in 2021 and beyond after the introduction of vaccines and updated guidelines; such studies are needed to contextualize ongoing COVID-19 treatment effectiveness studies during these time periods. This study describes utilization patterns for corticosteroids, interleukin-6 (IL-6) inhibitors, Janus kinase inhibitors, and remdesivir among hospitalized adults with COVID-19, over the entire hospitalization, and within hospitalization periods categorized by respiratory support requirements. This descriptive cohort study included United States adults hospitalized with COVID-19 admitted from 1 January 2021 through 1 February 2022; data included HealthVerity claims and hospital chargemaster. The number and distribution of patients were reported for the first 3 drug regimen lines initiated. The cohort included 51 066 patients; the most common initial drug regimens were corticosteroids (23.4%), corticosteroids plus remdesivir (25.1%), and remdesivir (4.4%). IL-6 inhibitors and Janus kinase inhibitors were included in later drug regimens and were more commonly administered with both corticosteroids and remdesivir than with corticosteroids alone. IL-6 inhibitors were more commonly administered than Janus kinase inhibitors when patients received high-flow oxygen or ventilation. These findings provide important context for comparative studies of COVID-19 treatments with study periods extending into 2021 and later. While prescribing generally aligned with National Institutes of Health COVID-19 treatment guidelines during this period, these findings suggest that prescribing preference, potential confounding by indication, and confounding by prior/concomitant use of other therapeutics should be considered in the design and interpretation of comparative studies.
Sections du résumé
Background
UNASSIGNED
There is a dearth of drug utilization studies for coronavirus disease 2019 (COVID-19) treatments in 2021 and beyond after the introduction of vaccines and updated guidelines; such studies are needed to contextualize ongoing COVID-19 treatment effectiveness studies during these time periods. This study describes utilization patterns for corticosteroids, interleukin-6 (IL-6) inhibitors, Janus kinase inhibitors, and remdesivir among hospitalized adults with COVID-19, over the entire hospitalization, and within hospitalization periods categorized by respiratory support requirements.
Methods
UNASSIGNED
This descriptive cohort study included United States adults hospitalized with COVID-19 admitted from 1 January 2021 through 1 February 2022; data included HealthVerity claims and hospital chargemaster. The number and distribution of patients were reported for the first 3 drug regimen lines initiated.
Results
UNASSIGNED
The cohort included 51 066 patients; the most common initial drug regimens were corticosteroids (23.4%), corticosteroids plus remdesivir (25.1%), and remdesivir (4.4%). IL-6 inhibitors and Janus kinase inhibitors were included in later drug regimens and were more commonly administered with both corticosteroids and remdesivir than with corticosteroids alone. IL-6 inhibitors were more commonly administered than Janus kinase inhibitors when patients received high-flow oxygen or ventilation.
Conclusions
UNASSIGNED
These findings provide important context for comparative studies of COVID-19 treatments with study periods extending into 2021 and later. While prescribing generally aligned with National Institutes of Health COVID-19 treatment guidelines during this period, these findings suggest that prescribing preference, potential confounding by indication, and confounding by prior/concomitant use of other therapeutics should be considered in the design and interpretation of comparative studies.
Identifiants
pubmed: 37496608
doi: 10.1093/ofid/ofad339
pii: ofad339
pmc: PMC10368445
doi:
Types de publication
Journal Article
Langues
eng
Pagination
ofad339Informations de copyright
Published by Oxford University Press on behalf of Infectious Diseases Society of America 2023.
Déclaration de conflit d'intérêts
Potential conflicts of interest. S. E. V., P. G., A. B., E. B., E. M. G., N. M. G., and V. F. are employees of Aetion, Inc, with stock options. All other authors report no potential conflicts.
Références
Pharmacoepidemiol Drug Saf. 2022 Jul;31(7):804-809
pubmed: 35426202
JAMA Netw Open. 2021 May 3;4(5):e2110775
pubmed: 34019090
Drugs. 2020 Dec;80(18):1961-1972
pubmed: 33151482
J Med Econ. 2022 Jan-Dec;25(1):287-298
pubmed: 35114896
Cancer Discov. 2020 Oct;10(10):1514-1527
pubmed: 32699031
JAMA Netw Open. 2020 Dec 1;3(12):e2029058
pubmed: 33301018
PLoS One. 2021 Dec 28;16(12):e0261707
pubmed: 34962924
J Med Virol. 2021 Sep;93(9):5367-5375
pubmed: 33913536
Clin Infect Dis. 2022 Aug 24;75(1):e450-e458
pubmed: 34596223
Am J Health Syst Pharm. 2020 Oct 30;77(22):1885-1892
pubmed: 32712675
Ann Intern Med. 2021 Oct;174(10):1395-1403
pubmed: 34399060
Pharmacoepidemiol Drug Saf. 2022 Jul;31(7):721-728
pubmed: 35373865
Medicine (Baltimore). 2021 Jan 15;100(2):e23923
pubmed: 33466134
Infez Med. 2022 Mar 1;30(1):86-95
pubmed: 35350268
JAMA. 2020 Jun 23;323(24):2524-2526
pubmed: 32463459