Objectives: We sought to analyze treatment patterns for patients with adult-onset Still’s disease (AOSD), systemic juvenile idiopathic arthritis (sJIA), familial Mediterranean fever (FMF), and other periodic fever syndromes (PFS) in the United States, and their potential implications on patients with refractory Still’s disease (SD).

Methods: A retrospective longitudinal analysis of the US Komodo HealthMap claims database was conducted including patients with at least two confirmatory diagnoses of an autoinflammatory disease, 3 years of follow-up, and 1 year prior medical history from 2016–2023.

Results: A total of 14,177 unique patients were identified as receiving first-line therapy for the diseases of interest during the study period. A majority (37%) received glucocorticoids (GC) as the first-line (1L) therapy, followed by nonsteroidal anti-inflammatory drugs (28%), biologics (12%), non-biologic disease-modifying antirheumatic drugs (nbDMARDS) (11%), colchicine (9%), and immunosuppressants (2%). Approximately 82% of patients advanced to receive second-line (2L) therapy and a further 56% received third-line (3L) therapy. GC use was reduced in 2L (13%) and 3L (8%), whereas biologics and nbDMARDS increased to 15% and 21%, and 23% and 31%, for 2L and 3L, respectively. This suggests that a substantial number of patients may have uncontrolled disease. Within the biologics, the use of canakinumab was substantially lower, with 7%, 11%, and 14% in 1L, 2L, and 3L, respectively, owing to its reserved use in patients after failure on other therapies.

Conclusion: Patients with SD, FMF, and other PFS cycle through several lines of therapy that are likely to have an impact on their well-being, treatment satisfaction, and costs. Greater efforts are required to identify patients with severe and/or refractory disease who may benefit from receiving newer therapies, such as biologics, earlier in their treatment plan.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: Narin Yasar Stock/other equities from Novartis Gene Therapies, Inc., Employee of Novartis Gene Therapies, Inc., Siobhan O’Brien Stock/other equities from Novartis Ireland, Ltd., Employee of Novartis Ireland, Ltd., Keith Peres Da Costa Contracted by Novartis Gene Therapies, Inc., for this research and analysis., Contracted by Novartis Gene Therapies, Inc., for this research and analysis., Walter Toro Stock/other equities from Novartis Gene Therapies, Inc., Employee of Novartis Gene Therapies, Inc., Anish Patel Stock/other equities from Novartis Gene Therapies, Inc., Employee of Novartis Gene Therapies, Inc., Kasem Akhras Stock/other equities from Novartis Gene Therapies, Inc., Employee of Novartis Gene Therapies, Inc.