Objective: Glucocorticoids (GCs) are standard treatment in Duchenne muscular dystrophy (DMD) but may increase healthcare resource utilization (HCRU) due to treatment-related adverse outcomes. This study examined the association between GC duration and HCRU in a real-world US cohort.
Methods: This retrospective cohort study used 2017–2022 Medicaid claims data for male DMD patients aged ≤30 years, grouped by GC duration: <20, 20–60, or >60 months. HCRU outcomes included inpatient admissions (including length of stay [LOS]), emergency room (ER), and outpatient visits, classified as GC- or non-GC-related. Regressions estimated HCRU, adjusting for age, race/ethnicity, Charlson Comorbidity Index, duration of follow-up, and GC switching. Adverse outcomes were summarized descriptively to contextualize outpatient utilization.
Results: Among 1,365 male DMD patients (mean age 11.6 years; mean GC use 45.5 months), mean LOS for GC-related inpatient admission was 11.0 days (<20), 9.2 (20–60), and 7.6 (>60); mean ER visits were 6.3, 4.8, and 5.2, respectively. Adjusted results found inpatient and ER utilization did not significantly differ by GC duration. GC-related outpatient visits increased with duration (8.2 vs. 10.6 vs. 14.5; p < 0.001) but represented a small portion of utilization. Notable GC-related outcomes—including infections, fractures, and cataracts—were observed with increasing rates across duration groups. Non-GC-related visits reflected hallmark DMD manifestations and the overall burden. Conclusion: While traditional GCs remain central to DMD care, longer use is associated with increased outpatient burden driven by both disease progression and treatment-related effects. These findings highlight the need for therapies that reduce overall disease burden and HCRU.