Kidney Week

Abstract: SA-PO472

Real-World Utilization of Prescription Medications to Manage Pain in Patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD)

Session Information

• ADPKD: Clinical Studies
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidney

• 1001 Genetic Diseases of the Kidney: Cystic

Authors

• Sanon, Myrlene, Otsuka Pharmaceutical Development & Commercialization, Inc. , Princeton, New Jersey, United States

Myrlene Sanon,

• Michalopoulos, Efstathios N., Otsuka Pharmaceutical Development & Commercialization, Inc., Rockville, Maryland, United States

Efstathios N. Michalopoulos,

• Stellhorn, Robert A., Otsuka Pharmaceutical Development & Commercialization, Inc. , Princeton, New Jersey, United States

Robert A. Stellhorn,

• Oberdhan, Dorothee, Otsuka Pharmaceutical Development & Commercialization, Inc., Rockville, Maryland, United States

Dorothee Oberdhan,

• Pao, Christina, Otsuka Pharmaceutical Development & Commercialization, Inc. , Princeton, New Jersey, United States

Christina Pao,

• Mccormick, Linda, Otsuka Pharmaceutical Development & Commercialization, Inc. , Princeton, New Jersey, United States

Linda Mccormick,

Background

ADPKD is a rare inherited disease characterized by progressive kidney enlargement and leads to end stage renal disease. Symptoms of ADPKD include chronic and transient types of pain in more than 80% of patients which can range in severity from mild to disabling. Understanding utilization of pain medications is important given pain has been linked to lower quality of life. Study aims to characterize management of pain through use of prescription medications.

Methods

Patients diagnosed with ADPKD (ICD-9/10 codes 753.12, 753.13, Q61.2, or Q61.3) were selected from Optum Clinformatics 2007-2017 US research database which is comprised of 7 million commercial and Medicare Advantage beneficiaries. Patients were aged 18 years or older, with continuous medical and pharmacy benefits for 6 months pre-index date (baseline period) and at least 6 months post-index date. The index date was the date of ADPKD diagnosis. Descriptive analyses described baseline patient characteristics, comorbidities, and utilization of pain medications by drug class during one-year post index-date. Included pain medications were selected per literature assessment of common pharmacologic treatments for the management of non-neuropathic and neuropathic pain syndromes.

Results

8,984 ADPKD patients met study inclusion criteria. Mean age was 57 years (SD=17) and 50% male. Mean follow-up time was 36 months (SD=27). At baseline, the mean Charlson comorbidity score was 1.86 and common medical comorbidities included hypertension (65%), diabetes (25%), chronic pulmonary disorder (14%), depression (9%), and anxiety (8%). Seventy percent (N=6,285) received at least one prescription for a medication commonly used to treat pain during one-year post index. Opioids were used by 50% of patients, followed by corticosteroids (31%), hypnotics including benzodiazepines (28%), antidepressants (20%), NSAIDS (18%), and anticonvulsants (11%).

Conclusion

Results show pharmacologic treatment of pain is common in patients with ADPKD with high use of opioids, corticosteroids, hypnotics, antidepressants, and NSAIDS. Use of NSAIDs in this population is relatively contraindicated suggesting higher severity of pain in this population and warrants further investigation.

Funding

• Commercial Support –