Real-World Health Care Resource Utilization, Adherence, and Persistence Following Subcutaneous IgPro20 Initiation Among US Patients with Chronic Inflammatory Demyelinating Polyneuropathy.
Kuatov Batyrkhan B, Weng Shicheng S, Hubsch Alphonse A, Undreiner Laurence L et al.
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare, inflammatory peripheral nervous system disorder. Intravenous immunoglobulin (IVIG) has been the standard maintenance therapy, but since 2018, Immune Globulin Subcutaneous (Human), 20% liquid (IgPro20), a subcutaneous immunoglobulin (SCIG) therapy, has offered an alternative, demonstrating benefit in maintaining CIDP improvement and remission. This study aimed to evaluate real-world healthcare resource utilization (HCRU), adherence, and persistence following IgPro20 initiation in patients with CIDP, given limited real-world evidence on these SCIG-related outcomes. This observational, descriptive study used Optum's de-identified Clinformatics® Data Mart Database (Optum® CDM) data to examine adults with CIDP initiating IgPro20 (index date). Adult patients with ≥ 2 CIDP diagnosis claims at least 14 days apart and ≥ 6 months of enrollment pre- and post-index between January 1, 2014 and December 31, 2024 were included. Those on other SCIG products were excluded. Patients with CIDP initiating IgPro20 (N = 207) were 53.6% male, with a median age of 60.00 and few comorbidities. Acute care utilization was low at baseline and decreased further following IgPro20 initiation, with inpatient and emergency department visits per patient per year (PPPY) decreasing from 0.52 to 0.42 and from 1.00 to 0.85, respectively. Overall, outpatient (OP) visits increased from 60.62 PPPY pre-initiation to 92.61 PPPY in month 1 post-initiation, driven by visits for CIDP-related home administration, notably for nursing/home-care for self-administration training. OP visits subsequently declined to 67.43 PPPY by month 6 (n = 141). Most patients (69.1%) were highly adherent, and 63.8% remained persistent at 6 months. Patients on IgPro20 administration demonstrated therapy adherence and decreased utilization of resource-intensive settings. While initial increases in outpatient and home care visits likely reflect training for at-home therapy, other outpatient healthcare utilization decreased. High persistence and adherence indicate sustained, uninterrupted therapy.