Real-World Treatment Patterns in Patients with Atopic Dermatitis Initiating Ruxolitinib Cream: A 12-Month Follow-Up Analysis of a US Payer Claims Database

Jinan Liu,1 Karishma Desai,2 Hung-Yuan P Chen,2 Chia-Chen Teng,2 Daniel Sturm,3 Grace E Stockbower,2 Vincent J Willey2 1US Health Economics and Outcomes Research, Incyte Corporation, Wilmington, DE, USA; 2Health Economics and Outcomes Research, Carelon Research, Inc., Wilmington, DE, USA; 3US Medical Affairs, Incyte Corporation, Wilmington, DE, USACorrespondence: Jinan Liu, US Health Economics and Outcomes Research, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, DE, 19803, USA, Tel +1 504 810 7282, Email [email protected]: This study describes a cohort of US commercially insured and Medicare Advantage patients with atopic dermatitis (AD) using ruxolitinib cream therapy and characterizes their treatment patterns before ruxolitinib cream initiation and during a 12-month follow-up.Patients and Methods: This retrospective, observational cohort study analyzed longitudinal administrative claims and social drivers of health data for patients diagnosed with AD and treated with ruxolitinib cream. Patient characteristics, treatment patterns, and healthcare resource utilization were described for the 6 months before and 12 months after ruxolitinib cream initiation.Results: The overall population (N=556) had a mean (SD) age of 40.3 (17.3) years and was 60.8% female, with 71.9% of patients being in the upper 2 socioeconomic status index score quartiles. Baseline predominant treatment patterns (overall cohort) included no treatment (26.6%), topical corticosteroids (53.4%), biologics (22.5%), systemic corticosteroids (20.9%), topical calcineurin inhibitors (14.9%), and topical phosphodiesterase-4 inhibitors (6.7%). Post-index treatment patterns showed a decreasing trend in corticosteroid use, with topical corticosteroid use dropping from 31.3% in months 1– 6 to 26.6% in months 7– 12, and systemic corticosteroid use stabilizing after an initial decrease (16.0% to 16.6%). However, the mean cumulative prednisone-equivalent dose among patients using systemic corticosteroids decreased overall by 28.9%, from 402.1 mg at baseline to 362.3 mg during months 1– 6 and to 285.7 mg during months 7– 12 of follow-up. Among the biologic-naïve cohort (n=431), 90.0% remained biologic-free during follow-up, and among the biologic-experienced cohort (n=125), 14.4% discontinued biologics during follow-up. The percentage of patients with healthcare encounters for AD decreased from 85.3% at baseline to 70.0% during follow-up.Conclusion: The reduced use of other AD treatments, including corticosteroids, and the high proportion of patients remaining biologic-free during the 12-month follow-up support the durability of the effectiveness of ruxolitinib as a therapeutic option for adults and adolescents with AD.Plain Language Summary: This study was conducted to see if using ruxolitinib cream was effective in treating eczema, also known as atopic dermatitis, over a full year of observing patients being treated with ruxolitinib cream. Insurance claims of patients with atopic dermatitis were evaluated for 6 months before and 12 months after starting ruxolitinib cream. Medication orders and healthcare provider visits to manage atopic dermatitis were observed to look for patterns. Before starting ruxolitinib cream, 27% of patients were untreated, 53% were treated with steroid creams, 23% were treated with advanced therapies, and 21% were treated with steroid tablets. After starting ruxolitinib cream, about half of the patients were able to stop using steroid creams, and one-fifth were able to stop taking steroid tablets. The patients who were taking steroid tablets before using ruxolitinib cream were able to decrease their dose by about 30%. Overall, most patients did not need to start more complex injectable therapies, and patients needed fewer doctor visits to manage their atopic dermatitis after starting ruxolitinib cream. This study suggests that ruxolitinib cream may be an effective treatment for adults and adolescents with atopic dermatitis.Keywords: medication trends, dermatological treatments, therapeutic outcomes, eczema, Janus kinase, topical