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Kuwana M, Saito A, Sakamoto W, Raabe C, Saito K. Incidence Rate and Prevalence of Systemic Sclerosis and Systemic Sclerosis-Associated Interstitial Lung Disease in Japan: Analysis Using Japanese Claims Databases. Adv Ther 2022; 39:2222-2235. [PMID: 35316503 PMCID: PMC9056456 DOI: 10.1007/s12325-022-02078-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 02/07/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Systemic sclerosis (SSc) is a complex autoimmune disease with increased mortality, and interstitial lung disease (ILD) is a major cause of death. There are no recent epidemiological data on SSc and SSc-associated ILD (SSc-ILD) in Japan and little is known about how patients with these diseases are treated. METHODS The incidence rate and prevalence of SSc and SSc-ILD in Japan were estimated using the Japanese Medical Data Centre (JMDC) database. The demographic and clinical characteristics of patients and the immunomodulatory medications they received were also assessed using JMDC and the Medical Data Vision (MDV) databases. All analyses were descriptive. RESULTS The overall incidence rates of SSc and SSc-ILD per 100,000 person-years were 6.6 (95% confidence interval [CI] 6.2-7.1) and 1.9 (95% CI 1.6-2.1), respectively, and the overall prevalence per 100,000 persons was 37.0 (95% CI 35.6-38.5) and 13.9 (95% CI 13.0-14.8), respectively. ILD was the most common comorbidity in patients with SSc present in approximately 30% of patients (JMDC, 29.3%; MDV, 30.1%). The immunomodulatory medications prescribed were similar in patients with SSc and SSc-ILD, and each of the medications in this analysis was prescribed in less than 15% of patients. CONCLUSION We have demonstrated that estimates of prevalence and incidence rates of SSc and SSc-ILD in Japan are comparable to similar database studies conducted in the USA, using a medical claims database. Only a small proportion of patients were receiving immunomodulatory treatments, suggesting undertreatment in Japan. Incidence Rate and Prevalence of Systemic Sclerosis and Systemic Sclerosis-associated Interstitial Lung Disease in Japan: Analysis Using Japanese Claims Databases-A Video Abstract. (MP4 68892 KB).
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Affiliation(s)
- Masataka Kuwana
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan.
| | - Aiko Saito
- Nippon Boehringer Ingelheim Co., Ltd, Tokyo, Japan
| | | | - Christina Raabe
- Boehringer Ingelheim International GmbH, Ingelheim Am Rhein, Germany
| | - Kumiko Saito
- Nippon Boehringer Ingelheim Co., Ltd, Tokyo, Japan
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Chang GC, Lam DCL, Tsai CM, Chen YM, Shih JY, Aggarwal S, Wang S, Kim SW, Kim YC, Wahid I, Li R, Lim DWT, Sriuranpong V, Chan RTT, Lorence RM, Carriere P, Raabe C, Cseh A, Park K. Experience from Asian centers in a named-patient-use program for afatinib in patients with advanced non-small-cell lung cancer who had progressed following prior therapies, including patients with uncommon EGFR mutations. Int J Clin Oncol 2021; 26:841-850. [PMID: 33783657 PMCID: PMC8055616 DOI: 10.1007/s10147-021-01869-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 01/01/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND This study evaluated outcomes among patients with advanced/metastatic non-small-cell lung cancer (NSCLC) treated at Asian centers participating in the global named-patient-use (NPU) program for afatinib. METHODS Patients had progressed after initial benefit with erlotinib or gefitinib, and/or had an EGFR or HER2 mutation, had no other treatment options, and were ineligible for afatinib trials. The recommended starting dose of afatinib was 50 mg/day. Dose modifications were allowed, and afatinib was continued as long as deemed beneficial. Response and survival information was provided voluntarily. Safety reporting was mandatory. RESULTS 2242 patients (26% aged ≥ 70 years, 96% with adenocarcinoma) received afatinib at centers in 10 Asian countries. Most were heavily pre-treated, including prior treatment with erlotinib or gefitinib. Of 1281 patients tested, 1240 had EGFR mutations (common: 1034/1101; uncommon: 117/1101). There were no new safety signals, the most common adverse events being rash and diarrhea. Objective response rate (ORR) was 24% overall (n = 431 with data available), 27% for patients with common EGFR mutations (n = 230) and 28% for those with uncommon mutations (n = 32); median time to treatment failure (TTF) in these groups was 7.6 months (n = 1550), 6.4 months (n = 692) and 8.4 months (n = 83), respectively. In patients with EGFR exon 20 insertions (n = 23) and HER2 mutations (n = 12), median TTF exceeded 12 months. CONCLUSIONS Patient outcomes in this study were similar to those reported in the analysis of the global NPU. Afatinib achieved clinical benefits in patients with refractory NSCLC. ORR and TTF were similar between patients with tumors harboring uncommon and common EGFR mutations.
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Affiliation(s)
- Gee-Chen Chang
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, No. 1650, Section 4, Taiwan Boulevard, Xitun District, Taichung, Taiwan.
- Division of Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
- Institute of Medicine and School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
| | | | | | - Yuh-Min Chen
- Department of Chest Medicine, Taipei Veterans General Hospital, and School of Medicine, National Yang-Ming Medical University, Taipei, Taiwan
| | | | | | | | - Sang-We Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young-Chul Kim
- Chonnam National University, Hwasun Hospital, Jeonnam, Republic of Korea
| | - Ibrahim Wahid
- Beacon International Specialist Centre, Selangor, Malaysia
| | - Rubi Li
- St Luke's Medical Center, Quezon City, Philippines
| | | | - Virote Sriuranpong
- Chulalongkorn University and the King Chulalongkorn Memorial Hospital, Pathumwan, Bangkok, Thailand
| | | | | | | | - Christina Raabe
- Boehringer Ingelheim International GmbH, Ingelheim Am Rhein, Germany
| | | | - Keunchil Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Li Q, Wallace L, Patnaik P, Alves M, Gahlemann M, Kohlbrenner V, Raabe C, Wang JR, Garry EM. Disease frequency, patient characteristics, comorbidity outcomes and immunosuppressive therapy in systemic sclerosis and systemic sclerosis-associated interstitial lung disease: a US cohort study. Rheumatology (Oxford) 2021; 60:1915-1925. [PMID: 33155024 PMCID: PMC8023990 DOI: 10.1093/rheumatology/keaa547] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/29/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To investigate prevalence estimates and incidence rates (IRs) for SSc and SSc-associated interstitial lung disease (SSc-ILD) cohorts and describe patient characteristics, immunosuppressive therapy (IST) and comorbid outcomes among incident SSc and SSc-ILD cohorts. METHODS Data were obtained from the US IBM MarketScan (2008-2017) claims database using algorithms developed with expert consultation. For the SSc cohort, newly diagnosed patients (aged ≥18 years) had one or more diagnostic claim for SSc. For the SSc-ILD cohort, patients had an additional ILD claim. Sensitivity analyses using two or more claims or alternative ILD diagnostic codes were also conducted. RESULTS When requiring one or more diagnostic claim, the prevalence of SSc and SSc-ILD per 100 000 persons was 72.1 and 19.0. The IR for SSc and SSc-ILD per 100 000 person-years was 18.3 and 4.3. Sensitivity analyses requiring two or more claims yielded much lower prevalence (SSc: 41.5; SSc-ILD: 13.3) and IR (SSc: 8.8; SSc-ILD: 1.6) estimates. Patients with SSc-ILD were older, with increased comorbidities and diagnostic procedures at baseline. MTX and MMF were the most common ISTs; 12.7% of the SSc-ILD cohort received therapy at baseline vs 8.2% for SSc. A total of 42.5% and 45.0% of the SSc and SSc-ILD cohorts, respectively, started a stable IST regimen and 21.7% and 19.4% of these had an escalation. Skin disorders were the most common comorbid outcome in both cohorts during follow-up. CONCLUSIONS SSc, with or without associated ILD, is a rare disease in the US. Newly diagnosed patients with SSc-ILD had received more IST and had more comorbidities compared with newly diagnosed SSc.
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Affiliation(s)
- Qiang Li
- Department of Epidemiology, Boehringer Ingelheim (China) Investment Co. Ltd., Beijing, China
| | - Laura Wallace
- Global Epidemiology and Real World Evidence, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA
| | - Padmaja Patnaik
- Global Epidemiology and Real World Evidence, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA
| | - Margarida Alves
- Inflammation Medicine, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | | | - Veronika Kohlbrenner
- Global Epidemiology and Real World Evidence, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA
| | - Christina Raabe
- Inflammation Medicine, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
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Déruaz‐Luyet A, Raabe C, Garry EM, Brodovicz KG, Lavery LA. Incidence of lower extremity amputations among patients with type 1 and type 2 diabetes in the United States from 2010 to 2014. Diabetes Obes Metab 2020; 22:1132-1140. [PMID: 32090430 PMCID: PMC7318669 DOI: 10.1111/dom.14012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 02/12/2020] [Accepted: 02/19/2020] [Indexed: 12/17/2022]
Abstract
AIM To compare the incidence of lower extremity amputation (LEA) among patients with type 1 diabetes (T1D) and patients with type 2 diabetes (T2D) with those without diabetes using US commercial claims and to assess the presence of key co-morbidities and precipitating factors at the time of the LEA. METHODS Cohorts were defined via IBM MarketScan research databases for beneficiaries with T1D and T2D during 2010-2014. For each T1D and T2D patient, one patient without a prior diabetic claim matched on calendar time, sex and age, was randomly selected. Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals. RESULTS Among the matched cohorts of 120 129 T1D patients and 1.7 million T2D patients, the incidence of LEA was higher among patients with T1D than patients with T2D, with the most frequent cases being minor LEAs (4.85 and 1.53 per 1000 patient years [PY], respectively), largely toe amputations (4.49 and 1.43 per 1000 PY, respectively). Compared with non-diabetic patients matched on age, sex and calendar time, T1D and T2D patients had more co-morbidities and a higher incidence of LEA (6.02 vs. 0.14 per 1000 PY; aHR, 22.47 [16.42-30.73] and 1.90 vs. 0.23 per 1000 PY; aHR, 4.64 [4.32-4.98]). CONCLUSIONS Our data showed a higher incidence of LEA, especially minor LEA, in patients with T1D and T2D compared with those without diabetes, with a greater risk among patients with T1D than patients with T2D. Accounting for known and measurable risk factors for LEA reduced the relative hazard by nearly 50%; the majority of LEA cases were minor LEAs and toe amputations.
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Affiliation(s)
| | | | | | | | - Lawrence A. Lavery
- Department of Plastic SurgeryUniversity of Texas Southwestern Medical CenterDallasTexas
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Gayle A, Schoof N, Alves M, Clarke D, Raabe C, Das P, Del Galdo F, Maher TM. Healthcare Resource Utilization Among Patients in England with Systemic Sclerosis-Associated Interstitial Lung Disease: A Retrospective Database Analysis. Adv Ther 2020; 37:2460-2476. [PMID: 32319038 PMCID: PMC7467474 DOI: 10.1007/s12325-020-01330-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Systemic sclerosis-associated interstitial lung disease (SSc-ILD) places a substantial burden on patients and healthcare systems. The objectives of this study were to describe clinical characteristics and assess healthcare resource utilization and costs of patients with SSc-ILD in England, compared with patients with non-pulmonary organ involvement related to SSc (SSc-OOI). METHODS This population-based retrospective study used data from the Clinical Practice Research Datalink linked to Hospital Episode Statistics. Data were extracted from medical records dated January 1, 2005 to March 31, 2016. Patients with SSc were identified and placed in subgroups based on organ involvement: SSc-ILD, SSc-OOI, and both (SSc-ILD-OOI). Patients with SSc-ILD-OOI were included in both the SSc-ILD and SSc-OOI subgroups. All-cause healthcare costs, excluding medication costs, were calculated to 2016 British pounds sterling (£). RESULTS This study included 675 patients with SSc: 174 (26%) had neither ILD nor other organ involvement (OOI); 127 (19%) had SSc-ILD; 477 (71%) had SSc-OOI; 103 (15%) had SSc-ILD-OOI. Age-weighted median [interquartile range (IQR)] annual healthcare costs per patient were: £1496 (£664-£2817) in SSc only; £6375 (£3451-£15,041) in SSc-ILD; £4084 (£1454-£10,105) in SSc-OOI; £6632 (£4023-£17,009) in SSc-ILD-OOI. In multivariate analysis, older age at diagnosis, diagnosis of anemia, and number of comorbid diseases were associated with higher yearly healthcare costs. CONCLUSION The annual healthcare cost for patients with SSc-ILD is substantial, and higher than that of patients with SSc-OOI or SSc only. These results quantify the economic burden of SSc-ILD in a real-world setting, and highlight the need for treatment of this disease.
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Affiliation(s)
| | - Nils Schoof
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | - Margarida Alves
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | | | - Christina Raabe
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | | | | | - Toby M Maher
- Fibrosis Research Group, National Heart and Lung Institute, Imperial College London, London, UK.
- Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK.
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Chang G, Lam C, Tsai C, Chen Y, Shih J, Aggarwal S, Wang S, Kim S, Kim Y, Wahid I, Li R, Lim W, Sriuranpong V, Chan T, Lorence R, Carriere P, Raabe C, Cseh A, Park K. P1.01-11 Named Patient Use Program for Afatinib in Advanced NSCLC with Progression on Prior Therapy: Experience from Asian Centers. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ney S, Raabe C, Breuer U, Laage-Gaupp A, Michaellis U, Oswald S, Schäfer J, Schäfer K, Stein S, Kuhnke N, Berweck S, Mall V, Staudt M. Beeinflusst die kortikospinale (Re)Organisation bei unilateraler Zerebralparese das Ansprechen auf Constraint-Induced Movement Therapy? physioscience 2010. [DOI: 10.1055/s-0029-1245405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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