Multiple Biologics for Multiple T2 Diseases: A Pharmacoepidemiological Algorithm for Sorting Out Patients by Indication

Abstract

Background

Several biologics (Bx) and targeted synthetic drugs (TSD) exist to treat T2 diseases, including chronic spontaneous urticaria (CSU), severe asthma (SA), chronic rhinosinusitis with nasal polyposis (CRSwNP) or atopic dermatitis (AD).

Objective

To identify patients treated with Bx/TSD from a dynamic dispensing database using an algorithm-based methodology.

Methods

We used the LRx database (Lifelink Treatment dynamics, IQVIA) which covers nearly 45% of the French retail pharmacies. Patients who had at least one Bx/TSD dispensing from April 2021 to March 2022 were included. An algorithm was designed to determine the indication of the Bx/TSD prescription analyzing all previous drug dispensation since March 2012 following a 3-steps procedure.

Results

A total of 21,677 patients received at least one Bx/TSD between March 2021 and April 2022. The algorithm identified 91.7% (n = 19,884) patients with a T2 disease (AD = 18.4%, CRSwNP = 1.5%, SA = 59.5%, and CSU = 12.4%), the rest having either an association of diseases (1%) or an undetermined one (7.3%). SA was the main reason for Bx/TSD initiation (52%), followed by AD (29%), CSU (14%) and CRSwNP (5%). For SA patients already under biologic at entry, omalizumab was the most frequently prescribed (48%) followed by benralizumab, mepolizumab (22% each) and dupilumab (8%). Dupilumab was mostly prescribed for AD patients (89% for patient-initiated vs 96% for patient-renewed) followed by baricitinib.

Conclusion

The algorithm was able to identify patients with T2 diseases under Bx/TSD treatments. This tool may help to follow the evolution of prescription patterns in the future.

Plain Language Summary

Nowadays, physicians have a choice of multiple biologics. Although some prospective cohorts of patients receiving those therapeutics exist, there are very few large up-to-date databases. Our algorithm based on a nationwide dynamic dispensing database was able to identify the T2 diseases of patients under biologics or targeted synthetic drugs and to characterize this population. This is a step toward a better understanding and monitoring of prescription patterns in a nationwide setting.

Keywords:

• severe asthma
• atopic dermatitis
• nasal polyposis
• urticaria
• T2 diseases
• biologics

Abbreviations

AD, atopic dermatitis; CRSwNP, chronic rhinosinusitis with nasal polyps; CSU, chronic spontaneous urticaria; OCS, oral corticosteroids; LRx, Lifelink Treatment dynamics; RA, rheumatoid arthritis; SA, severe asthma.

Acknowledgments

The authors would like to thank the IQVIA Team and particularly Deborah Desprez, Eric Martinho and Daniel Poitevin.

Disclosure

A.B. received payment or honoraria for lectures, presentations, speakers, bureaus, manuscript writing or educational events from AstraZeneca, GSK, Sanofi, Chiesi, Regeneron, ABScience, Novartis, and was principal investigator in clinical trials for AstraZenaca, GSK and Boehringer Ingelheim. J.C. received payment or honoraria for lectures, presentations, speakers, bureaus, manuscript writing or educational events from AstraZeneca, GSK, Sanofi, Chiesi. V.D. received payment or honoraria for lectures, presentations, speakers, bureaus, manuscript writing or educational events from ABBVIE, Janssen, Lilly, Novartis and Sanofi. R.J. reports personal fees from IQVIA, during the conduct of the study; personal fees from Sanofi, outside the submitted work. M.M is affiliated with IQVIA. The authors report no other conflicts of interest in this work.