Introduction

The impact of the COVID-19 pandemic on routine medical care may result in altered healthcare resource use in patients with immune-mediated conditions. The aim of this study was to determine the impact of treatment interruptions in patients with and without COVID-19 infections who were treated with targeted immunomodulators (TIMs) in the USA.

Methods

Data from the IBM^® MarketScan^® Research Databases were analyzed in patients with immune-mediated conditions from January 1, 2018, through December 31, 2020. Healthcare resource use (HCRU) including hospitalizations, emergency department (ED) visits, in-person outpatient visits, and respiratory outcomes was assessed in a cohort of patients without COVID-19 who had uninterrupted versus interrupted TIM use. The impact of treatment interruption on HCRU and respiratory outcomes was also evaluated in a cohort of patients with COVID-19. Results from adjusted logistic regression were reported as adjusted odds ratios (aORs) with 95% confidence intervals.

Results

Approximately 25% of patients in both the COVID-19 (N = 787) and non-COVID-19 cohorts (N = 77,178) experienced interruptions in TIM therapy. In the non-COVID-19 cohort, the likelihood of being hospitalized was 20% less in patients with uninterrupted versus interrupted TIM use (aOR = 0.80, 95% CI 0.71–0.90). Patients with uninterrupted TIM use had a similar likelihood of an ED visit (aOR = 0.99, 95% CI 0.91–1.08) and respiratory outcome (aOR = 0.97, 95% CI 0.71–1.31) versus patients with interrupted TIM use. The likelihood of having an in-person outpatient visit was 87% greater in patients with uninterrupted versus interrupted TIM use (aOR = 1.87, 95% CI 1.81–1.94). Similar findings were observed in the COVID-19 cohort.

Conclusion

This analysis of real-world claims data showed that uninterrupted TIM use was not associated with an increased likelihood of hospitalizations, ED visits, or negative respiratory outcomes compared to interrupted TIM use among patients with immune-mediated conditions, regardless of COVID-19 diagnosis.

中文翻译：

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在 COVID-19 大流行期间接受靶向免疫调节剂治疗的免疫介导疾病患者的医疗保健资源使用：回顾性索赔分析

介绍

COVID-19 大流行对常规医疗保健的影响可能会导致免疫介导疾病患者的医疗资源使用改变。本研究的目的是确定治疗中断对在美国接受靶向免疫调节剂 (TIM) 治疗的 COVID-19 感染患者和未感染患者的影响。

方法

从 2018 年 1 月 1 日到 2020 年 12 月 31 日，对来自 IBM ^® MarketScan ^®研究数据库的数据进行了分析。医疗资源使用 (HCRU) 包括住院、急诊科 (ED) 就诊、亲自门诊在一组没有 COVID-19 的患者中评估了访问和呼吸结果，这些患者不间断地与间断地使用 TIM。还在一组 COVID-19 患者中评估了治疗中断对 HCRU 和呼吸系统结局的影响。调整后的逻辑回归结果报告为调整后的优势比 (aOR)，置信区间为 95%。

结果

在 COVID-19（N  = 787）和非 COVID-19 队列（N  = 77,178）中，大约 25% 的患者经历了 TIM 治疗中断。在非 COVID-19 队列中，与中断使用 TIM 相比，不间断使用 TIM 的患者住院的可能性降低了 20%（aOR = 0.80，95% CI 0.71–0.90）。与中断使用 TIM 的患者相比，不间断使用 TIM 的患者就诊的可能性（aOR = 0.99, 95% CI 0.91-1.08）和呼吸结局（aOR = 0.97, 95% CI 0.71-1.31）相似。不间断使用 TIM 的患者与间断使用 TIM 的患者进行面对面门诊就诊的可能性高 87%（aOR = 1.87，95% CI 1.81–1.94）。在 COVID-19 队列中也观察到了类似的发现。

结论

对现实世界索赔数据的分析表明，与免疫介导疾病患者中断使用 TIM 相比，无论 COVID-19 诊断如何，不间断使用 TIM 与住院、急诊就诊或负面呼吸结果的可能性增加无关。