目的:促性腺激素释放激素类似物是中枢性早熟(CPP)的首选治疗方法。这项研究描述了使用histrelin植入物或亮丙瑞林注射治疗的患者。
方法:使用美国索赔数据库来识别2010年4月至2017年11月之间年龄≤20岁且在指标治疗日期之前≥3个月和之后≥12个月的连续招募患者。
结果:总体而言,4,217名患者(histrelin,n=1,001;亮丙瑞林,n=3,216)进行了鉴定。在histrelin中,CPP诊断患者的百分比更高(96.5%)。亮丙瑞林(68.8%;p<0.0001)队列。在CPP(histrelin,n=966;亮丙瑞林,n=2,214),histrelin(9.0±2.0岁)和亮丙瑞林(9.1±2.3岁)治疗开始时的平均年龄相似,>50%的患者年龄在6-9岁之间。histrelin的平均治疗时间明显更长(26.7±14.8个月)亮丙瑞林(14.1±12.1个月;p<0.0001),并且在年轻患者组中更长。更多的患者从亮丙瑞林转换为histrelin(12.3%),反之亦然(3.6%;p<0.0001)。histrelin队列的中位年度总治疗费用略低($23,071[四分位数范围,$16,833-$31,050])比亮丙瑞林队列($27,021[四分位数范围,$18,314-$34,995];p<0.0001)。
结论:使用histrelin治疗的CPP患者的治疗时间较长,较低的指数治疗中断率,和较低的年度治疗费用与那些用亮丙瑞林治疗的。
OBJECTIVE: Gonadotropin-releasing hormone analogs are the treatment of choice for central precocious puberty (CPP). This study characterizes patients treated with histrelin implant or leuprolide injection.
METHODS: A US claims database was used to identify patients aged ≤20 years with ≥1 histrelin or leuprolide claim (index treatment) between April 2010 and November 2017 and continuous enrollment ≥3 months before and ≥12 months after the index treatment date.
RESULTS: Overall, 4,217 patients (histrelin, n=1,001; leuprolide, n=3,216) were identified. The percentage of patients with CPP diagnosis was greater in the histrelin (96.5%) vs. leuprolide (68.8%; p<0.0001) cohort. In patients with CPP (histrelin, n=966; leuprolide, n=2,214), mean age at treatment initiation was similar for histrelin (9.0 ± 2.0 years) and leuprolide (9.1 ± 2.3 years), with >50% of patients aged 6-9 years. Mean treatment duration was significantly longer for histrelin (26.7 ± 14.8 months) vs. leuprolide (14.1 ± 12.1 months; p<0.0001), and was longer in younger patient groups. More patients switched from leuprolide to histrelin (12.3%) than vice versa (3.6%; p<0.0001). Median annual total treatment costs were slightly lower for the histrelin cohort ($23,071 [interquartile range, $16,833-$31,050]) than the leuprolide cohort ($27,021 [interquartile range, $18,314-$34,995]; p<0.0001).
CONCLUSIONS: Patients with CPP treated with histrelin had a longer duration of treatment, lower rates of index treatment discontinuation, and lower annual treatment costs vs. those treated with leuprolide.