Session: MON 88-111-Cushing's Disease & Non-Functioning Hypothalamus-Pituitary Tumors
Poster Board MON-94
METHODS: Combining US claims databases (Thomson Reuters MarketScan Commercial; IMS Health PharMetrics), we identified and followed CD patients from day of first treatment until end of enrollment or 12/31/2010. CD patients were identified as those who had a claim with Cushing’s syndrome diagnosis and either benign pituitary adenomas diagnosis or hypophysectomy and newly treated in 2008 (no treatment in prior 6 months). A novel graphical methodology that displays treatment patterns for each patient, including color-coded treatment sequences and duration of each treatment in sequence, was applied and results were compared with summary statistics.
RESULTS: We identified 228 newly treated CD patients: 180 patients (78.9%) had surgery as their first observed treatment, 42 (18.4%) had pharmacologic therapy and 6 (2.6%) had radiotherapy. In those with surgery as first treatment, 172 had pituitary surgery and 8 had adrenalectomy. Dopamine agonists were used as first medical therapy in 24 patients (57.1%), ketoconazole in 17 (40.5%), and mitotane in one patient (2.4%). In 180 patients with surgery as first treatment, 15 (8.3%) had radiotherapy and 14 (7.8%) had medical treatment during follow-up. In 42 patients who had pharmacologic therapy as first treatment, 10 (23.8%) had surgery and 2 (4.8%) had radiotherapy during follow-up. Mean (median) duration of first pharmacologic therapy varied by drug: 369.5 days (245) for dopamine agonists, 157.1 (30) for ketoconazole, and 30.0 (30) for mitotane. Images revealed persistence and changes in treatment varied by initial therapy. Graphics will be presented.
CONCLUSIONS: This study addresses an unmet need for data on real-world treatment patterns for CD patients in the US. Data were provided for treatment rates and duration in a large sample of CD patients using two nationwide databases. Patient-level graphical analysis provided additional detailed information on treatment patterns.
Disclosure: MSB: Researcher, Novartis Pharmaceuticals. MPN: Employee, Novartis Pharmaceuticals. EC: Researcher, Novartis Pharmaceuticals. WHL: Employee, Novartis Pharmaceuticals. DC: Researcher, Novartis Pharmaceuticals.
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