Kuiper JG, van Herk-Sukel MPP, Castellsague J, Potttegard A, Berglind IA, Dedman D, Calingaert B, Hallas J, Sundstrom A, Gallagher AM, Kaye JA, Pardo C, Rothman KJ, Perez-Gutthann S. Utilization of tacrolimus and pimecrolimus in Europe: results from the JOint European Longitudinal Lymphoma and skin cancer Evaluation (JOELLE) study. Poster presented at the 32nd ICPE International Conference on Pharmacoepidemiology & Therapeutic Risk Management; August 28, 2016. Dublin, Ireland. [abstract] Pharmacoepidemiol Drug Saf. 2016 Aug; 25(Suppl 3):630-1.

BACKGROUND: Tacrolimus and pimecrolimus are indicated for the treatment of atopic dermatitis.

OBJECTIVES: To assess utilization of tacrolimus and pimecrolimus in children and adults from a study across health databases in four European countries.

METHODS: Multicenter database cohort study comprising the PHARMO Database Network in the Netherlands, Danish and Swedish national registers, and the UK Clinical Practice Research Datalink (CPRD). RTI-Health Solutions acted as coordinating center. New users of tacrolimus and pimecrolimus were selected from the date of first availability of tacrolimus (2002 in all data sources and pimecrolimus (2002 in Denmark and 2003 in the other data sources) through 2011. In Sweden, prescription data was available from 2006 and new users of tacrolimus and pimecrolimus were selected from that starting point. New users were identified by ATC codes in PHARMO, Denmark and Sweden, and by Gemscript codes in CPRD. Use was assessed for children (less than 18 years) and adults.

RESULTS: The study included 19,948 children and 66,127 adults treated with tacrolimus, and 23,840 children and 37,417 adults treated with pimecrolimus. Denmark and Sweden contributed the largest proportion of users (48% and 27%, respectively, children and adults combined). The median follow-up of new users of tacrolimus in children ranged from 2.2 years in Sweden to 4.2 years in CPRD, and in adults from 2.2 years in Sweden to 3.6 years in Denmark and CPRD. The median (min-max) number of tacrolimus prescriptions per patient in children ranged from 1 (1-46) in Sweden to 2 (1-132) in CPRD, and in adults from 1 (1-83) in Sweden to 1 (1-145) in CPRD. The utilization of pimecrolimus showed similar trends to that of tacrolimus in both children and adults. Few patients switched between tacrolimus and pimecrolimus.

CONCLUSIONS: Utilization of tacrolimus and pimecrolimus did not vary substantially across European data sources. Most patients received a single prescription. No large difference in utilization patterns was seen between tacrolimus and pimecrolimus.