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Oral Immunosuppressive Treatment of Myasthenia Gravis in Denmark: A Nationwide Drug Utilization Study, 1996-2013

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Pedersen, Emil Greve ; Hallas, Jesper ; Pottegård, Anton ; Hald, Stine Munk ; Jensen, Poul Erik Hyldgaard ; Gaist, David. / Oral Immunosuppressive Treatment of Myasthenia Gravis in Denmark : A Nationwide Drug Utilization Study, 1996-2013. In: Basic & clinical pharmacology & toxicology. 2018 ; Vol. 123, No. 4. pp. 486-493.

Bibtex

@article{ff58ddf99f504bddb62d2af7400d9129,
title = "Oral Immunosuppressive Treatment of Myasthenia Gravis in Denmark: A Nationwide Drug Utilization Study, 1996-2013",
abstract = "Although immunosuppressants in the treatment of myasthenia have been available for several decades, population-based studies describing drug utilization in myasthenia patients are scarce. We aimed in this study to describe the treatment of myasthenia in Denmark in more recent years with emphasis on use of oral immunosuppressant agents. We identified a nationwide cohort of incident myasthenia patients in Denmark from 1996 to 2013 and tracked their use of drugs over the entire period using data from nationwide registers. Patients with myasthenia were classified according to utilization of specific immunosuppressants (e.g. prednisolone) as 'never user' or 'ever user'. We used Kaplan-Meier (K-M) and proportion of patients covered (PPC) curves to describe treatment onset and termination. We identified 928 patients (52{\%} female) with incident myasthenia in the study period. Overall, 638 (69{\%}) were treated with prednisolone and 506 (55{\%}) with azathioprine. Treatment with prednisolone and azathioprine within 2 years of myasthenia diagnosis was initiated in 462 (56{\%}) and 366 (45{\%}). Only one of four myasthenia patients (n = 231) did not receive oral immunosuppressive treatment at any time in the study period. Prednisolone was stopped in most patients, whereas treatment with azathioprine was often continued throughout follow-up. In conclusion, we found that treatment of myasthenia in Denmark in recent years corresponded well to the expected clinical course of myasthenia and that most patients underwent long-term immunosuppression.",
keywords = "Administration, Oral, Age of Onset, Aged, Denmark/epidemiology, Drug Prescriptions, Drug Utilization Review, Female, Health Care Surveys, Humans, Immunosuppressive Agents/administration & dosage, Incidence, Male, Middle Aged, Myasthenia Gravis/diagnosis, Practice Patterns, Physicians'/trends, Registries, Time Factors, Treatment Outcome",
author = "Pedersen, {Emil Greve} and Jesper Hallas and Anton Potteg{\aa}rd and Hald, {Stine Munk} and Jensen, {Poul Erik Hyldgaard} and David Gaist",
note = "{\circledC} 2018 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).",
year = "2018",
month = "10",
doi = "10.1111/bcpt.13034",
language = "English",
volume = "123",
pages = "486--493",
journal = "Basic & Clinical Pharmacology & Toxicology Online",
issn = "1742-7843",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "4",

}

RIS

TY - JOUR

T1 - Oral Immunosuppressive Treatment of Myasthenia Gravis in Denmark

T2 - A Nationwide Drug Utilization Study, 1996-2013

AU - Pedersen, Emil Greve

AU - Hallas, Jesper

AU - Pottegård, Anton

AU - Hald, Stine Munk

AU - Jensen, Poul Erik Hyldgaard

AU - Gaist, David

N1 - © 2018 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

PY - 2018/10

Y1 - 2018/10

N2 - Although immunosuppressants in the treatment of myasthenia have been available for several decades, population-based studies describing drug utilization in myasthenia patients are scarce. We aimed in this study to describe the treatment of myasthenia in Denmark in more recent years with emphasis on use of oral immunosuppressant agents. We identified a nationwide cohort of incident myasthenia patients in Denmark from 1996 to 2013 and tracked their use of drugs over the entire period using data from nationwide registers. Patients with myasthenia were classified according to utilization of specific immunosuppressants (e.g. prednisolone) as 'never user' or 'ever user'. We used Kaplan-Meier (K-M) and proportion of patients covered (PPC) curves to describe treatment onset and termination. We identified 928 patients (52% female) with incident myasthenia in the study period. Overall, 638 (69%) were treated with prednisolone and 506 (55%) with azathioprine. Treatment with prednisolone and azathioprine within 2 years of myasthenia diagnosis was initiated in 462 (56%) and 366 (45%). Only one of four myasthenia patients (n = 231) did not receive oral immunosuppressive treatment at any time in the study period. Prednisolone was stopped in most patients, whereas treatment with azathioprine was often continued throughout follow-up. In conclusion, we found that treatment of myasthenia in Denmark in recent years corresponded well to the expected clinical course of myasthenia and that most patients underwent long-term immunosuppression.

AB - Although immunosuppressants in the treatment of myasthenia have been available for several decades, population-based studies describing drug utilization in myasthenia patients are scarce. We aimed in this study to describe the treatment of myasthenia in Denmark in more recent years with emphasis on use of oral immunosuppressant agents. We identified a nationwide cohort of incident myasthenia patients in Denmark from 1996 to 2013 and tracked their use of drugs over the entire period using data from nationwide registers. Patients with myasthenia were classified according to utilization of specific immunosuppressants (e.g. prednisolone) as 'never user' or 'ever user'. We used Kaplan-Meier (K-M) and proportion of patients covered (PPC) curves to describe treatment onset and termination. We identified 928 patients (52% female) with incident myasthenia in the study period. Overall, 638 (69%) were treated with prednisolone and 506 (55%) with azathioprine. Treatment with prednisolone and azathioprine within 2 years of myasthenia diagnosis was initiated in 462 (56%) and 366 (45%). Only one of four myasthenia patients (n = 231) did not receive oral immunosuppressive treatment at any time in the study period. Prednisolone was stopped in most patients, whereas treatment with azathioprine was often continued throughout follow-up. In conclusion, we found that treatment of myasthenia in Denmark in recent years corresponded well to the expected clinical course of myasthenia and that most patients underwent long-term immunosuppression.

KW - Administration, Oral

KW - Age of Onset

KW - Aged

KW - Denmark/epidemiology

KW - Drug Prescriptions

KW - Drug Utilization Review

KW - Female

KW - Health Care Surveys

KW - Humans

KW - Immunosuppressive Agents/administration & dosage

KW - Incidence

KW - Male

KW - Middle Aged

KW - Myasthenia Gravis/diagnosis

KW - Practice Patterns, Physicians'/trends

KW - Registries

KW - Time Factors

KW - Treatment Outcome

U2 - 10.1111/bcpt.13034

DO - 10.1111/bcpt.13034

M3 - Journal article

VL - 123

SP - 486

EP - 493

JO - Basic & Clinical Pharmacology & Toxicology Online

JF - Basic & Clinical Pharmacology & Toxicology Online

SN - 1742-7843

IS - 4

ER -

ID: 56324217