Healthcare resource utilization in early initiators of ravulizumab for treatment of generalized myasthenia gravis in the USA

Topic:

Clinical Management

Poster Number: P351

Author(s):

Riley Snook, MD, IU Health Physicians Neurology, Carmel, USA, Michael Blackowicz, MD, Alexion, AstraZeneca Rare Disease, Boston, MA, USA, Emma Weiskopf, MD, Alexion, AstraZeneca Rare Disease, Boston, MA, USA, Dan Fogarty, MPH, Definitive Healthcare LLC, Framingham, Neha Arora, BSc, Definitive Healthcare LLC, Framingham, Raghav Govindarajan, MD, HSHS Medical Group Multispecialty Care – St. Elizabeth's, O'Fallon

Generalized myasthenia gravis (gMG) is a debilitating autoimmune neuromuscular disease characterized by muscle weakness and fatigue. Ravulizumab, a complement component 5 inhibitor, is indicated for adults with gMG who are anti-acetylcholine receptor antibody-positive. The CHAMPION-MG study, in which the long-term safety and efficacy of ravulizumab were investigated, suggested early initiation of complement inhibitors could reduce disease burden. Here, we present real-world evidence demonstrating the impact of ravulizumab on gMG-related healthcare resource utilization in patients initiating treatment within 2 years of diagnosis. This was a retrospective cohort study of patients with gMG in the US Atlas Longitudinal Patient Database who received ravulizumab as a first-line biologic therapy; patients were included if they had ≥1 year of continuous follow-up, before and after initiation of ravulizumab, and were identified as early initiators (first dose of ravulizumab received within 2 years of their first gMG diagnostic claim). Patients were excluded if they had previously received other approved biologic therapies. Healthcare resource utilization among early initiators was compared between the pre-initiation and post-initiation periods. In total, 114 patients met the inclusion criteria. Among these patients, there was an average of 0.95 hospitalizations per patient per year in the pre-initiation period versus 0.23 in the post-initiation period: an 81% reduction in annual hospitalization rate after early initiation of ravulizumab (incidence rate ratio, 0.19; 95% CI: 0.12, 0.31; p<0.001). In the pre-initiation period, 39% of hospitalizations resulted in an ICU admission and 23% was followed by hospital readmission within 30 days, versus 29% and 13%, respectively, in the post-initiation period. In this study, ravulizumab early initiation was associated with significantly reduced healthcare resource utilization. Early initiation of potentially disease-modifying targeted treatments, such as terminal complement inhibitors, may have implications for the reduction of hospitalization and other healthcare resource use in patients with gMG.