Repository corticotropin injection in patients with advanced symptomatic sarcoidosis: retrospective analysis of medical records
Identifieur interne : 000C04 ( Ncbi/Checkpoint ); précédent : 000C03; suivant : 000C05Repository corticotropin injection in patients with advanced symptomatic sarcoidosis: retrospective analysis of medical records
Auteurs : Ishveen Chopra ; Yimin Qin ; John Kranyak ; Jack R. Gallagher ; Kylee Heap ; Susan Carroll ; George J. WanSource :
- Therapeutic Advances in Respiratory Disease [ 1753-4658 ] ; 2019.
Abstract
Repository corticotropin injection (RCI) has regulatory approval for many indications, including symptomatic sarcoidosis. This large case series of patients with advanced symptomatic sarcoidosis treated with RCI describes patient characteristics, RCI utilization patterns, concomitant therapies, and physicians’ assessments of treatment response.
Patients ⩾18 years with symptomatic sarcoidosis, treated with RCI in the previous 36 months, who had completed a course of RCI or received RCI for ⩾6 months at the time of data collection were included.
The study included 302 patients (mean age, 51 years; 52%, women) with a mean 4.8 years since initial diagnosis of sarcoidosis. Most patients (76%) had extrapulmonary involvement, primarily in the skin (28%), joints (25%), heart (22%), and eyes (22%); 34% had multiple (⩾2) organ involvement. The mean duration of RCI treatment was 32.5 weeks, with 61.6% of patients continuing RCI therapy for ⩾6 months. The RCI utilization pattern indicated an individualized approach to therapy, with a higher starting dose associated with a shorter duration of therapy compared with a lower starting dose. The percentage of patients who used corticosteroids decreased from 61.3% during the 3 months before initiation of RCI to 12.9% 3 months after RCI therapy; the mean daily dose of corticosteroid decreased from 18.2 mg to 9.9 mg. The proportion of patients given <10 mg/day of prednisone increased from 21% before RCI use to 47% 3 months after RCI use. According to physicians’ assessments of change in patients’ health status after RCI therapy, overall status improved in 95% of patients, overall symptoms in 73%, lung function in 38%, and inflammation in 33%.
The findings suggest that RCI is a viable treatment option for patients with advanced symptomatic sarcoidosis and provide insights on patient characteristics and practice patterns to help clinicians determine appropriate use.
Url:
DOI: 10.1177/1753466619888127
PubMed: 31722624
PubMed Central: 6856972
Affiliations:
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<author><name sortKey="Chopra, Ishveen" sort="Chopra, Ishveen" uniqKey="Chopra I" first="Ishveen" last="Chopra">Ishveen Chopra</name>
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<author><name sortKey="Qin, Yimin" sort="Qin, Yimin" uniqKey="Qin Y" first="Yimin" last="Qin">Yimin Qin</name>
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<author><name sortKey="Kranyak, John" sort="Kranyak, John" uniqKey="Kranyak J" first="John" last="Kranyak">John Kranyak</name>
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<author><name sortKey="Gallagher, Jack R" sort="Gallagher, Jack R" uniqKey="Gallagher J" first="Jack R." last="Gallagher">Jack R. Gallagher</name>
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<author><name sortKey="Heap, Kylee" sort="Heap, Kylee" uniqKey="Heap K" first="Kylee" last="Heap">Kylee Heap</name>
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<author><name sortKey="Carroll, Susan" sort="Carroll, Susan" uniqKey="Carroll S" first="Susan" last="Carroll">Susan Carroll</name>
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<author><name sortKey="Wan, George J" sort="Wan, George J" uniqKey="Wan G" first="George J." last="Wan">George J. Wan</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Repository corticotropin injection in patients with advanced symptomatic sarcoidosis: retrospective analysis of medical records</title>
<author><name sortKey="Chopra, Ishveen" sort="Chopra, Ishveen" uniqKey="Chopra I" first="Ishveen" last="Chopra">Ishveen Chopra</name>
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<author><name sortKey="Qin, Yimin" sort="Qin, Yimin" uniqKey="Qin Y" first="Yimin" last="Qin">Yimin Qin</name>
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<author><name sortKey="Kranyak, John" sort="Kranyak, John" uniqKey="Kranyak J" first="John" last="Kranyak">John Kranyak</name>
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<author><name sortKey="Gallagher, Jack R" sort="Gallagher, Jack R" uniqKey="Gallagher J" first="Jack R." last="Gallagher">Jack R. Gallagher</name>
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<author><name sortKey="Heap, Kylee" sort="Heap, Kylee" uniqKey="Heap K" first="Kylee" last="Heap">Kylee Heap</name>
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<author><name sortKey="Carroll, Susan" sort="Carroll, Susan" uniqKey="Carroll S" first="Susan" last="Carroll">Susan Carroll</name>
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<author><name sortKey="Wan, George J" sort="Wan, George J" uniqKey="Wan G" first="George J." last="Wan">George J. Wan</name>
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<series><title level="j">Therapeutic Advances in Respiratory Disease</title>
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<front><div type="abstract" xml:lang="en"><sec id="section1-1753466619888127"><title>Background:</title>
<p>Repository corticotropin injection (RCI) has regulatory approval for many indications, including symptomatic sarcoidosis. This large case series of patients with advanced symptomatic sarcoidosis treated with RCI describes patient characteristics, RCI utilization patterns, concomitant therapies, and physicians’ assessments of treatment response.</p>
</sec>
<sec id="section2-1753466619888127"><title>Methods:</title>
<p>Patients ⩾18 years with symptomatic sarcoidosis, treated with RCI in the previous 36 months, who had completed a course of RCI or received RCI for ⩾6 months at the time of data collection were included.</p>
</sec>
<sec id="section3-1753466619888127"><title>Results:</title>
<p>The study included 302 patients (mean age, 51 years; 52%, women) with a mean 4.8 years since initial diagnosis of sarcoidosis. Most patients (76%) had extrapulmonary involvement, primarily in the skin (28%), joints (25%), heart (22%), and eyes (22%); 34% had multiple (⩾2) organ involvement. The mean duration of RCI treatment was 32.5 weeks, with 61.6% of patients continuing RCI therapy for ⩾6 months. The RCI utilization pattern indicated an individualized approach to therapy, with a higher starting dose associated with a shorter duration of therapy compared with a lower starting dose. The percentage of patients who used corticosteroids decreased from 61.3% during the 3 months before initiation of RCI to 12.9% 3 months after RCI therapy; the mean daily dose of corticosteroid decreased from 18.2 mg to 9.9 mg. The proportion of patients given <10 mg/day of prednisone increased from 21% before RCI use to 47% 3 months after RCI use. According to physicians’ assessments of change in patients’ health status after RCI therapy, overall status improved in 95% of patients, overall symptoms in 73%, lung function in 38%, and inflammation in 33%.</p>
</sec>
<sec id="section4-1753466619888127"><title>Conclusions:</title>
<p>The findings suggest that RCI is a viable treatment option for patients with advanced symptomatic sarcoidosis and provide insights on patient characteristics and practice patterns to help clinicians determine appropriate use.</p>
<p><italic>The reviews of this paper are available via the supplemental material section.</italic>
</p>
</sec>
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