The Real-World Dispensing Patterns of Mycophenolic Acid and Calcineurin Inhibitors Across Selected Immune-Mediated Disorders: A Retrospective Pharmacy-Registry Drug-Utilization Study
The Patterns of Mycophenolic Acid and Calcineurin Inhibitors Across Selected Immune-Mediated Disorders
DOI:
https://doi.org/10.46966/msjar.v7i3.452Keywords:
Drug utilization; mycophenolate; calcineurin inhibitor; immune-mediated disease; pharmacy registry; real-world data.Abstract
Background: Mycophenolic acid (MPA) products and calcineurin inhibitors (CNIs) are used across a range of immune-mediated disorders, yet routine dispensing registers often lack the clinical detail needed to evaluate treatment appropriateness, effectiveness, or safety. Objective: To characterize encounter-level and patient-level dispensing patterns of MPA products and CNIs after exclusion of all records labeled nephrotic syndrome or systemic lupus erythematosus, and to identify data-quality priorities for future pharmacoepidemiologic surveillance. Methods: This retrospective repeated-encounter drug-utilization study analyzed eight consecutive monthly pharmacy spreadsheets. Eligible records required a patient identifier, sex, age, and a source-recorded diagnostic label. Diagnostic labels were preserved as recorded and were not independently adjudicated. Monthly activity was summarized at the dispensing-encounter level, whereas regimen patterns were summarized at the patient level using each patient’s latest record from a month with complete CNI ascertainment. Analyses were descriptive. Results: The restricted dataset contained 73 dispensing encounters from 17 unique patients across 14 source-recorded diagnostic categories. Women accounted for 48 encounters (65.8%); mean age was 40.4 years (SD 15.3), and median age was 42 years (IQR 32–52). Pulmonary fibrosis was the most frequent recorded label (13 encounters; 17.8%), followed by autoimmune myasthenia (8; 11.0%) and multiple sclerosis recorded as “M.S” (7; 9.6%). Sixteen patients had a latest record from a month with complete CNI ascertainment: 12 (75.0%) had MPA-only recording and four (25.0%) had CNI-only recording; no concurrent MPA-CNI recording was identified. Conclusions: These data only describe pharmacy activity and do not demonstrate treatment efficacy, safety or adherence to guidelines. Future research on the registry will focus on standardizing diagnostic coding, obtaining comprehensive exposure data and clinically relevant variables for monitoring and outcomes.rfeffdf
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