Effect of Selumetinib Treatment on Long-term Prescription Pain Medication Utilization in Adults: A Retrospective Study of a U.S. Claims Database
Genevieve Lyons1, Justin Jordan2, Terry Dettling1, Alyssa Bowling1, Ashwin Anand3, Mike Sicilia3, Julia Meade4
1AstraZeneca Rare Disease, 2University of Texas Southwestern Medical Center, 3Forian Inc., 4UPMC Children’s Hospital of Pittsburgh; University of Pittsburgh School of Medicine
Objective:
This retrospective claims analysis assessed the impact of selumetinib on prescription pain medication utilization (PPMU) in adults over a 3-year period.
Background:
Selumetinib (ARRY-142886, AZD6244), an oral inhibitor of mitogen-activated protein kinases 1 and 2, reduces plexiform neurofibroma size in patients with Neurofibromatosis Type 1. A real-world analysis showed consistent reductions in PPMU over 3 years in pediatric patients taking selumetinib. To date there are no real-world data on the impact of selumetinib on PPMU in adults.
Design/Methods:
Adults taking selumetinib were identified via a US claims database. Inclusion criteria were ≥3 selumetinib prescriptions (April 1, 2020−June 30, 2025), aged >21 years at selumetinib initiation, and ≥12 months of continuous enrollment and claim activity before and after the first selumetinib prescription. Follow-up was from selumetinib initiation (baseline) through the duration of treatment with selumetinib.
Results:
A total of 160 patients were included in the analysis (mean [standard deviation] age: 38.3 [13.0] years; female: 55%). PPMU steadily increased from 47% (n=68/144) 12 months prior to selumetinib initiation to 57% (n=91/160) at baseline. Post-selumetinib initiation, PPMU steadily reduced to 48% (n=41/86) at 1 year and 29% (n=7/24) at 3 years, representing around a two-fold reduction in PPMU. Gabapentin use declined from 29% at baseline to 13% at 3 years, and opioid use decreased from 14% at baseline to 8% at 3 years. An age- and sex-adjusted analysis using a generalized estimating equation model compared pre-selumetinib PPMU with post-selumetinib PPMU over 3 years, demonstrating a statistically significant relationship between duration of selumetinib treatment and reduced PPMU; for each year patients took selumetinib, probability of PPMU reduced by 19.5% (odds ratio 0.947 per 3 months; p=0.003).
Conclusions:
Consistent, lasting reductions in prescription pain medication utilization were observed over 3 years in adults taking selumetinib. These real-world findings support clinical trial evidence of the impact of selumetinib on pain.
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