Roflumilast Usage from 2010 to 2016: A Danish Nationwide Drug Utilization Study

Øyvind Nicolay Ulland Salvesen, Jesper Rømhild Davidsen, Anton Pottegård, Daniel Pilsgaard Henriksen*

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Resumé

Roflumilast, a phosphodiesterase-4-inhibitor, is marketed as add-on treatment to inhaled bronchodilators and corticosteroids in COPD patients with frequent exacerbations. Although marketed since 2010, usage pattern of roflumilast for an entire nation has not previously been explored. This study aimed to estimate the total utilization of roflumilast in Denmark during 2010 to 2016, using the Danish nationwide health registers. We identified 1573 individuals (47% males) who used roflumilast during the study period, of whom 705 (45%) redeemed only one prescription. Of all patients initiating roflumilast, 67% discontinued treatment within the first year. The rate of treatment initiation decreased 73% from 2011 (7.5/100,000 person-years) to 2016 (2.0/100,000 person-years) concurrent with a stable prevalence of 3.0–4.0/100,000 persons throughout the study period. The median duration of roflumilast use was 76 days. Patients with severe comorbidity tended to exhibit a lower degree of early discontinuation (Charlson Comorbidity Index 3+: odds ratio [OR]: 0.59; 95% confidence interval [CI] 0.33–1.04), as well as patients with a COPD-related admission within a year prior to roflumilast initiation (OR 0.62; 95% CI 0.49–0.80). The decreasing incidence and high level of early roflumilast discontinuation could be due to lack of benefit, a low awareness of romiflulast's indication among physicians, secondary to a challenging prescribing procedure or to adverse effects.

OriginalsprogEngelsk
TidsskriftBasic & Clinical Pharmacology & Toxicology
Vol/bind123
Udgave nummer3
Sider (fra-til)314-319
ISSN1742-7835
DOI
StatusUdgivet - sep. 2018

Fingeraftryk

Drug Utilization
Pharmaceutical Preparations
Chronic Obstructive Pulmonary Disease
Comorbidity
Odds Ratio
Phosphodiesterase 4 Inhibitors
Confidence Intervals
Roflumilast
Bronchodilator Agents
Denmark
Prescriptions
Adrenal Cortex Hormones
Health
Physicians
Incidence

Citer dette

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abstract = "Roflumilast, a phosphodiesterase-4-inhibitor, is marketed as add-on treatment to inhaled bronchodilators and corticosteroids in COPD patients with frequent exacerbations. Although marketed since 2010, usage pattern of roflumilast for an entire nation has not previously been explored. This study aimed to estimate the total utilization of roflumilast in Denmark during 2010 to 2016, using the Danish nationwide health registers. We identified 1573 individuals (47{\%} males) who used roflumilast during the study period, of whom 705 (45{\%}) redeemed only one prescription. Of all patients initiating roflumilast, 67{\%} discontinued treatment within the first year. The rate of treatment initiation decreased 73{\%} from 2011 (7.5/100,000 person-years) to 2016 (2.0/100,000 person-years) concurrent with a stable prevalence of 3.0–4.0/100,000 persons throughout the study period. The median duration of roflumilast use was 76 days. Patients with severe comorbidity tended to exhibit a lower degree of early discontinuation (Charlson Comorbidity Index 3+: odds ratio [OR]: 0.59; 95{\%} confidence interval [CI] 0.33–1.04), as well as patients with a COPD-related admission within a year prior to roflumilast initiation (OR 0.62; 95{\%} CI 0.49–0.80). The decreasing incidence and high level of early roflumilast discontinuation could be due to lack of benefit, a low awareness of romiflulast's indication among physicians, secondary to a challenging prescribing procedure or to adverse effects.",
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Roflumilast Usage from 2010 to 2016 : A Danish Nationwide Drug Utilization Study. / Salvesen, Øyvind Nicolay Ulland; Davidsen, Jesper Rømhild; Pottegård, Anton; Henriksen, Daniel Pilsgaard.

I: Basic & Clinical Pharmacology & Toxicology, Bind 123, Nr. 3, 09.2018, s. 314-319.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Roflumilast Usage from 2010 to 2016

T2 - A Danish Nationwide Drug Utilization Study

AU - Salvesen, Øyvind Nicolay Ulland

AU - Davidsen, Jesper Rømhild

AU - Pottegård, Anton

AU - Henriksen, Daniel Pilsgaard

N1 - This article is protected by copyright. All rights reserved.

PY - 2018/9

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N2 - Roflumilast, a phosphodiesterase-4-inhibitor, is marketed as add-on treatment to inhaled bronchodilators and corticosteroids in COPD patients with frequent exacerbations. Although marketed since 2010, usage pattern of roflumilast for an entire nation has not previously been explored. This study aimed to estimate the total utilization of roflumilast in Denmark during 2010 to 2016, using the Danish nationwide health registers. We identified 1573 individuals (47% males) who used roflumilast during the study period, of whom 705 (45%) redeemed only one prescription. Of all patients initiating roflumilast, 67% discontinued treatment within the first year. The rate of treatment initiation decreased 73% from 2011 (7.5/100,000 person-years) to 2016 (2.0/100,000 person-years) concurrent with a stable prevalence of 3.0–4.0/100,000 persons throughout the study period. The median duration of roflumilast use was 76 days. Patients with severe comorbidity tended to exhibit a lower degree of early discontinuation (Charlson Comorbidity Index 3+: odds ratio [OR]: 0.59; 95% confidence interval [CI] 0.33–1.04), as well as patients with a COPD-related admission within a year prior to roflumilast initiation (OR 0.62; 95% CI 0.49–0.80). The decreasing incidence and high level of early roflumilast discontinuation could be due to lack of benefit, a low awareness of romiflulast's indication among physicians, secondary to a challenging prescribing procedure or to adverse effects.

AB - Roflumilast, a phosphodiesterase-4-inhibitor, is marketed as add-on treatment to inhaled bronchodilators and corticosteroids in COPD patients with frequent exacerbations. Although marketed since 2010, usage pattern of roflumilast for an entire nation has not previously been explored. This study aimed to estimate the total utilization of roflumilast in Denmark during 2010 to 2016, using the Danish nationwide health registers. We identified 1573 individuals (47% males) who used roflumilast during the study period, of whom 705 (45%) redeemed only one prescription. Of all patients initiating roflumilast, 67% discontinued treatment within the first year. The rate of treatment initiation decreased 73% from 2011 (7.5/100,000 person-years) to 2016 (2.0/100,000 person-years) concurrent with a stable prevalence of 3.0–4.0/100,000 persons throughout the study period. The median duration of roflumilast use was 76 days. Patients with severe comorbidity tended to exhibit a lower degree of early discontinuation (Charlson Comorbidity Index 3+: odds ratio [OR]: 0.59; 95% confidence interval [CI] 0.33–1.04), as well as patients with a COPD-related admission within a year prior to roflumilast initiation (OR 0.62; 95% CI 0.49–0.80). The decreasing incidence and high level of early roflumilast discontinuation could be due to lack of benefit, a low awareness of romiflulast's indication among physicians, secondary to a challenging prescribing procedure or to adverse effects.

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JO - Basic & Clinical Pharmacology & Toxicology

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SN - 1742-7835

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