(185) Real-world analysis of treatment patterns and healthcare resource utilization among patients with alcohol-associated hepatitis from 2016 to 2024

Background: : Alcohol-associated hepatitis (AH) is characterized by acute liver injury, hepatic dysfunction, and high morbidity/mortality. There are limited data describing real-world treatment (tx) patterns and healthcare resource utilization (HCRU) in this population.

Objective: : To evaluate pharmacological tx patterns and both all-cause and AH-related HCRU in a real-world cohort of patients (pts) with AH.

Methods: : Adult pts with ≥2 inpatient claims for alcoholic hepatitis (ICD-10-CM codes K70.10 and K70.11) were identified from the Optum Clinformatics® Data Mart database between 2017 and 2024. Pts were required to have continuous enrollment for ≥12 months pre-index and ≥1 day post-index, with the index date defined as the date of first claim with an AH diagnosis (dx). AH-related HCRU was defined as a medical claim for an AH dx plus liver transplant, dialysis, or paracentesis; a dx of acute renal injury, hepatorenal syndrome, hepatic failure, hepatic encephalopathy, variceal bleeding, or sepsis; or a pharmacy claim for pentoxifylline or systemic corticosteroids within 7 days of the AH dx. HCRU was assessed descriptively during the baseline, fixed (3, 6, and 12 months), and variable follow-up (f/u) periods. Pharmacological tx patterns focused on outpatient alcohol use disorder (AUD) tx and first-line interventions occurring within 30 days of the initial tx.

Results: : A total of 2415 pts (64.8% male) met criteria for variable f/u, with a mean (SD) age of 53.9 (12.9) y. Overall, 23.4% of pts received AUD tx, including acamprosate, disulfiram, and naltrexone. During f/u, 33.8% of pts received lactulose, and 21.1% initiated lactulose as monotherapy. Pharmacological tx combinations for AUD were rare. At baseline, 91.1% and 61.9% of pts had ≥1 all-cause ambulatory and emergency department (ED) visit, respectively. During the 12-month fixed f/u period, 99.2% and 98.3% of pts had ≥1 all-cause ambulatory and ED visit, respectively. AH-related HCRU during this period included ambulatory visits in 27.6% of pts, inpatient stays in 59.1%, and ED visits in 51.7%. Over the variable f/u period, 96.2% of pts had all-cause ambulatory visits and 98.4% had all-cause ED visits; 74.2% and 66.7% of pts had AH-related inpatient and ED visits, respectively.

Conclusions: : Pts with AH experience a high burden of HCRU. Despite frequent engagement with the healthcare system, < 1 in 4 pts received pharmacological tx targeting AUD. These data highlight an unmet need for AH management and an opportunity for targeted interventions to improve outcomes and reduce HCRU.

Sponsorship:: Intercept Pharmaceuticals, Inc., a wholly owned subsidiary of Alfasigma S.p.A.