(358) Increased health care resource utilization in children and adolescents with Tourette syndrome treated with dopamine D2 receptor antagonists/partial agonists: an electronic health records database analysis

Background: : Tourette syndrome (TS) is a neurodevelopmental disorder characterized by motor and vocal tics. Dopamine D2 receptor antagonists/partial agonists (D2RAs; aripiprazole, haloperidol, and pimozide) are indicated for TS, but D2RAs are associated with multiple adverse effects. Health care resource utilization (HCRU) information in children and adolescents prescribed D2RAs for TS is lacking.

Objective: : To compare HCRU in D2RA-exposed versus D2RA non-exposed individuals with TS.

Methods: : Data were analyzed from the TriNetX Dataworks-USA Network database. The D2RA-exposed cohort was indexed on first D2RA record (2011-2021) with a prior TS diagnosis (ICD-9-CM:307.23/ICD-10-CM:F952); non-D2RA cohort was indexed on a randomly selected record with TS diagnosis (2011-2021). Additional criteria: 6-17 years and at least 1 provider encounter during baseline (18 months prior to index date) and during 18-month follow-up periods. Individuals in each cohort were matched 1:1, based on age group, index year, region, and sex. Incidence rates/risk ratios for all-cause/TS-related HCRU were calculated during follow-up.

Results: : A total of 1684 individuals (6-17 years) were matched in the D2RA and non-D2RA cohorts (median age, 13 years; 73.9% males). The most common first-month D2RAs were risperidone (40.3%) and aripiprazole (30.4%). Compared to the non-D2RA cohort, the D2RA cohort had higher all-cause HCRU: 1.7-fold higher emergency care (22.6 vs 38.7 per 100 person-years [100 PY]), 2.4-fold higher inpatient (10.3 vs 25.1 per 100 PY), and 2.0-fold higher outpatient (778.7 vs 1552.3 per 100 PY) encounters. Compared to the non-DR2A cohort, the D2RA cohort also had higher TS-related HCRU: 4.4-fold higher emergency care (1.5 vs 6.5 per 100 PY), 3.3-fold higher inpatient (1.9 vs 6.2 per 100 PY), and 2.5-fold higher outpatient (153.9 vs 386.2 per 100 PY) encounters. Similar results were observed after multivariable adjustment for demographics/clinical characteristics.

Conclusions: : Data highlight the high HCRU burden in children and adolescents with TS treated with D2RAs. Further research is needed to disentangle roles of medication class versus TS severity.

Sponsorship:: Emalex Biosciences, Inc.