299 Background: Patients with biochemically recurrent (BCR) nonmetastatic castration-sensitive prostate cancer (nmCSPC) who are identified as high-risk of developing metastases may benefit from earlier treatment. This study analyzed treatment patterns in these patients. Methods: The Adelphi Real World nmCSPC retrospective survey was completed by urologists and radiation oncologists in the US. For this analysis, data from medical charts for patients diagnosed with high-risk BCR nmCSPC from Jan 2021–Jul 2023 were extracted; physicians completed a chart for their last 6–8 patients. Data were analyzed descriptively for first line (1L) treatment received (regardless of time) since high-risk BCR diagnosis for the total patient sample and subgroups of interest. Physicians documented those with no treatment as on observation. Results: Aggregated data were analyzed for 376 patients with high-risk BCR nmCSPC; 252 (67%) had prostate-specific antigen doubling time (PSADT) ≤9 months after BCR and initial definitive therapy of radiotherapy (RT) and/or radical prostatectomy (RP). Overall, 84% were treated by urologists and 16% by radiation oncologists. Median age was 70 years; 64% were White, 31% were Black/African American. Median PSA at high-risk BCR diagnosis was 5 ng/mL. Median follow-up after high-risk BCR diagnosis was 249 days. Median time between high-risk BCR diagnosis and initiation of 1L treatment was 17 days. Most common 1L treatments were androgen deprivation therapy (ADT) alone, salvage RT, novel hormonal therapy (NHT) + ADT, and observation alone. For patients on observation alone, median follow-up after high-risk BCR diagnosis was 181 days. Few numerical differences were seen in treatment patterns depending on how patients were determined as high-risk (Table). Patients treated by urologists rather than radiation oncologists had numerically higher proportions of 1L treatment with NHT + ADT (21% / 2%) and observation alone (17% / 8%), and numerically lower proportions of ADT alone (27% / 34%) and salvage RT (12% / 44%). Conclusions: First line treatments were typically initiated rapidly following high-risk BCR nmCSPC diagnosis, with only 15% of patients receiving observation alone during available follow-up. [Table: see text]
4579 Background: Intravesical Bacillus Calmette-Guerin (BCG) induction + maintenance (I+M) is the standard of care for high-risk NMIBC. Disease recurrence and progression is common. The studies investigating programmed cell death-1/programmed death-ligand 1 (PD-[L]1) inhibitors + BCG aim to enhance treatment outcomes and reduce burden in BCG naïve high-risk NMIBC. There is limited evidence on patient preferences for these combination regimens. Methods: A discrete choice experiment quantified preferences for attribute levels related to BCG and PD-(L)1 inhibitors. Attributes and levels were informed by a literature review, patient interviews, regulatory scientific advice, clinical experts and a patient advocate. Patients completed hypothetical choice tasks describing administration mode and frequency for PD-(L)1 inhibitors and BCG (induction [I]; I+M), median event-free survival (EFS) and adverse events (AEs: bladder AEs; chronic endocrine conditions; serious immune AEs). Hierarchical Bayesian modelling estimated preference weights (PWs) for attribute levels. PWs identified level combinations with the lowest choice probability. Relative importance (RI) was calculated by systematically varying attribute levels and capturing the gain in choice probability. Results: 150 patients (77 BCG-naïve; 73 BCG-experienced) in the United States completed the survey. Clinician-confirmed diagnosis (17%) and/or self-reported ongoing or planned BCG I+M (99%) was obtained. The sample was 51% male, had a median age of 63 years (49-74) and diverse by race (Caucasian 46%; African American/Black 27%; Other 27%) and ethnicity (Hispanic/Latino/Spanish 21%). EFS was the most important attributes to patients (RI 17.2), followed by bladder AEs (RI 16.4) and serious immune AEs (RI 14.0). Administration attributes were important (RI 9-9.9), but less important than other attributes. PWs show that short duration ( < 1 minute) subcutaneous (SC) injections was the most preferred PD-(L)1 route and shorter BCG schedule was preferred. Conclusions: Findings highlight the value of prolonging EFS, effective clinical management of BCG AEs and reducing administration burden in future BCG + PD(L)1 regimens. Attribute Level Mean PW 95% CI (±) RI*(%) EFS (months) 362722 3.46-1.03-2.43 0.280.110.22 17.2 Bladder AEs (%) 03575 2.98-0.10-2.88 0.290.120.26 16.4 Serious immune AEs (%) 01020 1.40-0.09-1.31 0.220.090.18 14.0 Chronic endocrine conditions (%) 0510 0.99-0.08-0.91 0.150.080.16 12.6 PD-(L)1 frequency (weeks) 643 0.45-0.10-0.35 0.100.100.06 9.9 PD-(L)1 administration route and time SC <1 minuteSC 7-10 minutesIV 30-60 minutes 0.150.06-0.21 0.090.100.08 9.5 BCG schedule II+M 0.25-0.25 0.140.14 9.0 *Sums to 88.7. The remaining 11.3 corresponds to an attribute used for analysis only. CI: confidence interval; IV: intravenous infusion.
INTRODUCTION Atopic dermatitis (AD) is an increasingly prevalent chronic heterogeneous inflammatory skin disorder characterised by pruritus and eczematous lesions. Recent guidelines recommend using topical therapies for AD management. We describe the treatment satisfaction and disease activity in adolescent and adult patients with moderate-to-severe AD using topical therapies in the US. Methods Data were drawn from the 2025 Adelphi Real World Topical Experience AD Disease Specific Programme, a cross-sectional survey with elements of retrospective data collection in the US. Health care practitioners (HCPs, dermatologists/allergists/immunologists/nurse practitioners/physician assistants) provided information on clinical characteristics, including physician-determined current disease severity (moderate/severe AD), treatment satisfaction, disease control, and reasons for dissatisfaction with current treatment. Patients (≥13 years) were required to be currently on topical therapy (corticosteroids/calcineurin inhibitors) for their AD, either as monotherapy or in combination with another treatment. Patients were stratified by type of treatment: topical monotherapy (no concomitant systemic treatment, TM) vs topical + advanced systemic (oral JAK-i or biologic, TAS). All analyses were descriptive. Results Sample (mean age=32.2 years, 55% female) included TM: n=115 (84% moderate, 16% severe) and TAS: n=46 (87% moderate, 13% severe) patients with AD. Current head and neck involvement was reported in 61% TM and 67% TAS; current upper limb involvement in 77% TM and 83% TAS; current trunk involvement in 52% TM and 52% TAS; and current lower limb involvement in 69% TM and 65% TAS. Current mean (SD) BSA was reported as 17.2% (16.5) TM and 18.6% (18.7) TAS. Physician-determined success of treatment was reported in 58% TM and 61% TAS. HCPs reported they were “satisfied, and I believe this is the best control that can be realistically achieved for this patient” in 31% TM and 46% TAS; “satisfied, but I believe better control can be achieved for this patient” in 51% TM and 33% TAS; “not satisfied, and I believe this is the best control that can be realistically achieved for this patient” in 1% TM and 7% TAS; and “not satisfied, but I believe better control can be achieved for this patient” in 17% TM and 15% TAS. The main reason for dissatisfaction was “AD is still impacting the patient's quality of life” among TM and TAS, followed by “Lack of skin clearance” in TM and “Patient not satisfied” and “Persistent skin changes” in TAS. At data collection, flaring was observed in 33% TM (flare severity: 61% moderate, 34% severe) and 30% TAS (flare severity: 64% moderate, 36% severe). Mean (SD) number of patient-reported flares in the past 12 months was 3.2 (2.2) TM and 4.1 (3.9) TAS; however, only 25% TM and 27% TAS patients indicated reporting every flare to their HCP. Conclusions While most HCPs were satisfied with the current treatment, over one-third still believed that better control can be achieved. Additionally, patients on topicals with or without systemic medication were actively flaring, and most patients did not report every flare to their HCP. Results indicate unmet treatment needs and a need for better awareness in patients with AD.
RATIONALE: Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare anti-neutrophil cytoplasmic antibody-associated vasculitis that confers significant disease burden.This real-world study aimed to identify current treatment patterns of patients with EGPA. METHODS: Data were drawn from the Adelphi Real World EGPA Disease Specific Programme™, a cross-sectional survey of physicians and patients in France, Germany, Italy, Spain, the UK, and the US from July–December 2023. Data on current and ≤5 previous treatments were retrieved from patient medical history. Outputs were stratified based on whether patients were currently prescribed anti-interleukin-5/Rα therapy (anti-IL-5/Rα; mepolizumab or benralizumab), or another treatment such as glucocorticoids, immunosuppressants, intravenous immunoglobulin and plasma exchange, or another biologic. At time of data capture, mepolizumab was the only biologic approved for EGPA. Analyses were descriptive. RESULTS: In all patients (N=503), mean (SD) age was 49.5 (15.3) years; 50% were female. Overall, 70% (n=351) of patients were receiving oral or parenteral glucocorticoids. The median dose of glucocorticoids (combined oral/parenteral) was 8 mg/day, with the greatest proportion of patients receiving 4.1–7.5 mg/day (37%; n=131), and 21% (n=72) receiving >20 mg/day. In total, 36% (n=183), 50% (n=251) and 27% (n=138) of patients were receiving immunosuppressant, biologic and anti-IL-5/Rα treatment, respectively. For patients receiving immunosuppressant or anti-IL-5/Rα treatment, 52% (n=96/183) and 51% (n=70/138), respectively, were receiving combination therapy with a glucocorticoid. Of 171 patients with ≥1 diagnosed comorbidity, 57% (n=97) were receiving anti-IL-5/Rα treatment for EGPA; physicians considered comorbidities when deciding to initiate anti-IL-5/Rα treatment in 52% (n=50) of these patients. Anti-IL-5/Rα treatment was most prescribed by pulmonologists (n=30/138; 22%), allergists/immunologists (n=25/138; 18%), gastroenterologists (n=21/138; 15%), and hematologists (n=21/138; 15%). Key reasons for prescribing anti-IL-5/Rα treatment were speed of onset (n=17/34; 50%), symptomatic relief (n=17/34; 50%), to reduce dose/duration of glucocorticoids (n=15/34; 44%), and to improve quality of life (n=15/34; 44%). For patients assessed by physicians as having moderate or severe disease at start of treatment, 85% (n=94/111) of those receiving an anti-IL-5/Rα had high levels of physician satisfaction with their current disease control. Additional results are summarized in Table 1. CONCLUSION: In a real-world clinical setting, many patients with EGPA were prescribed glucocorticoids, with more than 1 in 5 receiving >20 mg/day, and 27% received anti-IL-5/Rα treatment. Anti-IL-5/Rα treatment was most often prescribed by pulmonologists and allergists/immunologists for reasons such as speed of onset, symptomatic relief, to reduce dose/duration of glucocorticoids and to improve quality of life. Confidential – Not for Public Consumption or Distribution
