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Open Forum Infect Dis
. 2023 Jul 10;10(7):ofad339.
doi: 10.1093/ofid/ofad339. eCollection 2023 Jul. A Descriptive Cohort Study of Drug Utilization Patterns Among Patients Hospitalized With Coronavirus Disease 2019 in the United States, January 2021-February 2022
Sarah E Vititoe 1 , Priya Govil 1 , Aidan Baglivo 1 , Elisha Beebe 1 , Elizabeth M Garry 1 , Nicolle M Gatto 1 , Tamar Lasky 2 , Aloka Chakravarty 2 , Marie C Bradley 3 , Silvia Perez-Vilar 3 , Donna R Rivera 4 , Kenneth Quinto 5 , Andrew Clerman 6 , Anil Rajpal 7 , Vera Frajzyngier 1
Affiliations
Background: There is a dearth of drug utilization studies for coronavirus disease 2019 (COVID-19) treatments in 2021 and beyond after the introduction of vaccines and updated guidelines; such studies are needed to contextualize ongoing COVID-19 treatment effectiveness studies during these time periods. This study describes utilization patterns for corticosteroids, interleukin-6 (IL-6) inhibitors, Janus kinase inhibitors, and remdesivir among hospitalized adults with COVID-19, over the entire hospitalization, and within hospitalization periods categorized by respiratory support requirements.
Methods: This descriptive cohort study included United States adults hospitalized with COVID-19 admitted from 1 January 2021 through 1 February 2022; data included HealthVerity claims and hospital chargemaster. The number and distribution of patients were reported for the first 3 drug regimen lines initiated.
Results: The cohort included 51 066 patients; the most common initial drug regimens were corticosteroids (23.4%), corticosteroids plus remdesivir (25.1%), and remdesivir (4.4%). IL-6 inhibitors and Janus kinase inhibitors were included in later drug regimens and were more commonly administered with both corticosteroids and remdesivir than with corticosteroids alone. IL-6 inhibitors were more commonly administered than Janus kinase inhibitors when patients received high-flow oxygen or ventilation.
Conclusions: These findings provide important context for comparative studies of COVID-19 treatments with study periods extending into 2021 and later. While prescribing generally aligned with National Institutes of Health COVID-19 treatment guidelines during this period, these findings suggest that prescribing preference, potential confounding by indication, and confounding by prior/concomitant use of other therapeutics should be considered in the design and interpretation of comparative studies.
Keywords: COVID-19; Janus kinase inhibitors; drug utilization; interleukin-6 inhibitors.
. 2023 Jul 10;10(7):ofad339.
doi: 10.1093/ofid/ofad339. eCollection 2023 Jul. A Descriptive Cohort Study of Drug Utilization Patterns Among Patients Hospitalized With Coronavirus Disease 2019 in the United States, January 2021-February 2022
Sarah E Vititoe 1 , Priya Govil 1 , Aidan Baglivo 1 , Elisha Beebe 1 , Elizabeth M Garry 1 , Nicolle M Gatto 1 , Tamar Lasky 2 , Aloka Chakravarty 2 , Marie C Bradley 3 , Silvia Perez-Vilar 3 , Donna R Rivera 4 , Kenneth Quinto 5 , Andrew Clerman 6 , Anil Rajpal 7 , Vera Frajzyngier 1
Affiliations
- PMID: 37496608
- PMCID: PMC10368445 (available on 2024-07-10)
- DOI: 10.1093/ofid/ofad339
Background: There is a dearth of drug utilization studies for coronavirus disease 2019 (COVID-19) treatments in 2021 and beyond after the introduction of vaccines and updated guidelines; such studies are needed to contextualize ongoing COVID-19 treatment effectiveness studies during these time periods. This study describes utilization patterns for corticosteroids, interleukin-6 (IL-6) inhibitors, Janus kinase inhibitors, and remdesivir among hospitalized adults with COVID-19, over the entire hospitalization, and within hospitalization periods categorized by respiratory support requirements.
Methods: This descriptive cohort study included United States adults hospitalized with COVID-19 admitted from 1 January 2021 through 1 February 2022; data included HealthVerity claims and hospital chargemaster. The number and distribution of patients were reported for the first 3 drug regimen lines initiated.
Results: The cohort included 51 066 patients; the most common initial drug regimens were corticosteroids (23.4%), corticosteroids plus remdesivir (25.1%), and remdesivir (4.4%). IL-6 inhibitors and Janus kinase inhibitors were included in later drug regimens and were more commonly administered with both corticosteroids and remdesivir than with corticosteroids alone. IL-6 inhibitors were more commonly administered than Janus kinase inhibitors when patients received high-flow oxygen or ventilation.
Conclusions: These findings provide important context for comparative studies of COVID-19 treatments with study periods extending into 2021 and later. While prescribing generally aligned with National Institutes of Health COVID-19 treatment guidelines during this period, these findings suggest that prescribing preference, potential confounding by indication, and confounding by prior/concomitant use of other therapeutics should be considered in the design and interpretation of comparative studies.
Keywords: COVID-19; Janus kinase inhibitors; drug utilization; interleukin-6 inhibitors.