Uptake and Use of Biologic Therapies in Paediatric Immune‐Mediated Inflammatory Diseases: An Australian Population‐Based Study
Jun Ni Ho, Jodie Hillen, Natasha Nassar, Helga Zoega, Timothy Beukelman, Nicole Pratt, Benjamin DanielsABSTRACT
Purpose
To quantify the real‐world use and describe characteristics of paediatric patients initiating biologic medicines for immune‐mediated inflammatory diseases (IMIDs).
Methods
Dispensing claims for Australians aged less than 18 years were used to examine uptake and use trends of nine biologic medicines used for the treatment of IMIDs. A 15% random sample of the population was used for dispensings between 2013 and 2017, and a 30% sample for dispensings between 2017 and 2020. Incidence and prevalence rates of use per 1 000 000 population per year were calculated. Patient demographics at the time of first dispensing were determined and the number of unique medicines dispensed per person across the study period was calculated.
Results
Incidence of use of biologics increased from 108 per million in 2014 to 192 per million in 2020, while prevalence increased from 352 per million to 877 per million over the same period. 1131 children were dispensed at least one biologic medicine; infliximab, adalimumab or etanercept accounted for 80% of dispensings. Mean age at first dispensing was 14 years (standard deviation: 3 years) and 51% were male. Of children initiated on biologics, 55% were first dispensed treatment for inflammatory bowel diseases and 29% for inflammatory arthropathies. While most children were dispensed only one unique biologic medicine, 15% were dispensed two, and 3% three or more over the study period.
Conclusions
These results suggest that children remain on treatment for extended periods of time and nearly one in five children were dispensed multiple biologic medicines. Post‐market studies should be prioritised to monitor safety among these groups.