Patient Support Programs Associated With Greater Likelihood of Controlled AS

Canadian patients who receive brand-name adalimumab (Humira) to treat ankylosing spondylitis (AS) are eligible for a patient support program, provided by drug maker AbbVie, that includes personalized services such as coaching phone calls before and after initiating treatment.

A newly published study, funded by AbbVie and published in Rheumatology and Therapy, used de-identified patient-level records from the Quintiles IMS longitudinal prescription transactions database to assess the likelihood of patients who were enrolled in the patient program to achieve controlled AS, as measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), compared with patients who were not enrolled in the program.

The researchers identified 249 patients with AS who received their first adalimumab prescription between January 2010 and October 2015, and who were persistent on their adalimumab therapy. Of this group, 123 patients received coaching calls as part of the patient program. All of the patients had a BASDAI assessment between 90 days before and 30 days after the date of the first prescription, and a follow-up assessment 6 to 18 months later.

The researchers found that, at the follow-up BASDAI assessment, 80% (n = 98) of patients who received coaching as part of the assistance program had reached controlled disease, versus 68% of patients (n = 86) who did not receive any coaching. After adjusting for age, sex, region, biologic-naïve status, disease status at baseline, and time between assessments, coaching was associated with an increased probability of controlled AS (risk ratio, 1.23; 95% CI, 1.06-1.42; P  = .0055).

While previous research has demonstrated that patient programs are associated with improved adherence to adalimumab therapy, “To our knowledge, the [coaching] is the first example of a patient-centric service that was associated with improved clinical outcomes,” write the authors. These data, they say, should both encourage physicians to enroll patients in assistance programs, and encourage drug developers to invest in and refine these programs to help patients beyond providing medications.

The researchers acknowledge that this study had a relatively small sample size, and that limited data on baseline disease characteristics or lifestyle factors were available for the patients. However, they suggest that future investigation of these additional factors may be conducted through self-reporting by patients, including in-depth patient interviews.

Reference

Bessette L, Lebovic G, Millson B, et al. Impact of the adalimumab patient support program on clinical outcomes in ankylosing spondylitis: results from the COMPANION study. [Published online April 9, 2018] Rheumatol Ther. doi: 10.1007/s4074.