Intravenous edaravone treatment in ALS and survival: An exploratory, retrospective, administrative claims analysis
Summary: Background: We aimed to evaluate overall survival in US patients with amyotrophic lateral sclerosis (ALS) treated with intravenous (IV) edaravone compared with those not treated with IV edaravone in a real-world setting. Methods: This exploratory retrospective comparative effectiveness obs...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-10-01
|
| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537022003200 |
| _version_ | 1828291864612044800 |
|---|---|
| author | Benjamin Rix Brooks James D. Berry Malgorzata Ciepielewska Ying Liu Gustavo Suarez Zambrano Jeffrey Zhang Melissa Hagan |
| author_facet | Benjamin Rix Brooks James D. Berry Malgorzata Ciepielewska Ying Liu Gustavo Suarez Zambrano Jeffrey Zhang Melissa Hagan |
| author_sort | Benjamin Rix Brooks |
| collection | DOAJ |
| description | Summary: Background: We aimed to evaluate overall survival in US patients with amyotrophic lateral sclerosis (ALS) treated with intravenous (IV) edaravone compared with those not treated with IV edaravone in a real-world setting. Methods: This exploratory retrospective comparative effectiveness observational analysis included patients with ALS who were enrolled in an administrative claims database from 8 August 2017 to 31 March 2020. Propensity score matching identified IV edaravone-treated patients (cases) and non-edaravone-treated patients (controls) matched for covariates: age, race, geographic region, sex, pre-index disease duration, insurance, history of cardiovascular disease, riluzole prescription, gastrostomy tube placement, artificial nutrition, noninvasive ventilation, and all-cause hospitalisation. For cases, the index date was the date of the first claim for IV edaravone. For controls, it was the date IV edaravone was available (8 August 2017). The effect of IV edaravone on all-cause mortality was estimated with shared frailty Cox regression analysis. Findings: 318 cases were matched to 318 controls. In both groups, 208 patients (65.4%) had a history of riluzole prescription. As of 31 March 2021, there were 155 deaths (48.7%) among the cases and 196 among the controls (61.6%). Median overall survival time was 29.5 months with edaravone and 23.5 months without, respectively, and the risk of death was 27% lower in cases than in controls (HR, 0.73; 95% CI, 0.59–0.91; p=0.005). Interpretation: In this real-world analysis, IV edaravone treatment in a large predominantly riluzole-treated US cohort was associated with prolonged overall survival compared with not using IV edaravone. Data from adequately powered RCTs are needed to support this finding. Funding: Funded by Mitsubishi Tanabe Pharma America. |
| first_indexed | 2024-04-13T10:59:11Z |
| format | Article |
| id | doaj.art-b262c9a377a5482cac0b6d76743fb534 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-04-13T10:59:11Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-b262c9a377a5482cac0b6d76743fb5342022-12-22T02:49:28ZengElsevierEClinicalMedicine2589-53702022-10-0152101590Intravenous edaravone treatment in ALS and survival: An exploratory, retrospective, administrative claims analysisBenjamin Rix Brooks0James D. Berry1Malgorzata Ciepielewska2Ying Liu3Gustavo Suarez Zambrano4Jeffrey Zhang5Melissa Hagan6Atrium Health Neurosciences Institute, Carolinas Medical Center, University of North Carolina School of Medicine–Charlotte Campus, Charlotte, NC, United StatesHealey Center for ALS, Massachusetts General Hospital, Boston, MA, United StatesMedical Affairs, Mitsubishi Tanabe Pharma America, Inc., Jersey City, NJ, United States; Corresponding author at: Mitsubishi Tanabe Pharma America, Inc, 525 Washington Blvd., Suite 2620, Jersey City, NJ 07310, United States.Princeton Pharmatech, Princeton, NJ, United StatesMedical Affairs, Mitsubishi Tanabe Pharma America, Inc., Jersey City, NJ, United StatesPrinceton Pharmatech, Princeton, NJ, United StatesMedical Affairs, Mitsubishi Tanabe Pharma America, Inc., Jersey City, NJ, United StatesSummary: Background: We aimed to evaluate overall survival in US patients with amyotrophic lateral sclerosis (ALS) treated with intravenous (IV) edaravone compared with those not treated with IV edaravone in a real-world setting. Methods: This exploratory retrospective comparative effectiveness observational analysis included patients with ALS who were enrolled in an administrative claims database from 8 August 2017 to 31 March 2020. Propensity score matching identified IV edaravone-treated patients (cases) and non-edaravone-treated patients (controls) matched for covariates: age, race, geographic region, sex, pre-index disease duration, insurance, history of cardiovascular disease, riluzole prescription, gastrostomy tube placement, artificial nutrition, noninvasive ventilation, and all-cause hospitalisation. For cases, the index date was the date of the first claim for IV edaravone. For controls, it was the date IV edaravone was available (8 August 2017). The effect of IV edaravone on all-cause mortality was estimated with shared frailty Cox regression analysis. Findings: 318 cases were matched to 318 controls. In both groups, 208 patients (65.4%) had a history of riluzole prescription. As of 31 March 2021, there were 155 deaths (48.7%) among the cases and 196 among the controls (61.6%). Median overall survival time was 29.5 months with edaravone and 23.5 months without, respectively, and the risk of death was 27% lower in cases than in controls (HR, 0.73; 95% CI, 0.59–0.91; p=0.005). Interpretation: In this real-world analysis, IV edaravone treatment in a large predominantly riluzole-treated US cohort was associated with prolonged overall survival compared with not using IV edaravone. Data from adequately powered RCTs are needed to support this finding. Funding: Funded by Mitsubishi Tanabe Pharma America.http://www.sciencedirect.com/science/article/pii/S2589537022003200Amyotrophic lateral sclerosisEdaravoneReal-world evidenceSurvival |
| spellingShingle | Benjamin Rix Brooks James D. Berry Malgorzata Ciepielewska Ying Liu Gustavo Suarez Zambrano Jeffrey Zhang Melissa Hagan Intravenous edaravone treatment in ALS and survival: An exploratory, retrospective, administrative claims analysis EClinicalMedicine Amyotrophic lateral sclerosis Edaravone Real-world evidence Survival |
| title | Intravenous edaravone treatment in ALS and survival: An exploratory, retrospective, administrative claims analysis |
| title_full | Intravenous edaravone treatment in ALS and survival: An exploratory, retrospective, administrative claims analysis |
| title_fullStr | Intravenous edaravone treatment in ALS and survival: An exploratory, retrospective, administrative claims analysis |
| title_full_unstemmed | Intravenous edaravone treatment in ALS and survival: An exploratory, retrospective, administrative claims analysis |
| title_short | Intravenous edaravone treatment in ALS and survival: An exploratory, retrospective, administrative claims analysis |
| title_sort | intravenous edaravone treatment in als and survival an exploratory retrospective administrative claims analysis |
| topic | Amyotrophic lateral sclerosis Edaravone Real-world evidence Survival |
| url | http://www.sciencedirect.com/science/article/pii/S2589537022003200 |
| work_keys_str_mv | AT benjaminrixbrooks intravenousedaravonetreatmentinalsandsurvivalanexploratoryretrospectiveadministrativeclaimsanalysis AT jamesdberry intravenousedaravonetreatmentinalsandsurvivalanexploratoryretrospectiveadministrativeclaimsanalysis AT malgorzataciepielewska intravenousedaravonetreatmentinalsandsurvivalanexploratoryretrospectiveadministrativeclaimsanalysis AT yingliu intravenousedaravonetreatmentinalsandsurvivalanexploratoryretrospectiveadministrativeclaimsanalysis AT gustavosuarezzambrano intravenousedaravonetreatmentinalsandsurvivalanexploratoryretrospectiveadministrativeclaimsanalysis AT jeffreyzhang intravenousedaravonetreatmentinalsandsurvivalanexploratoryretrospectiveadministrativeclaimsanalysis AT melissahagan intravenousedaravonetreatmentinalsandsurvivalanexploratoryretrospectiveadministrativeclaimsanalysis |