Prurigo nodularis is an itchy skin disease with unknown epidemiology. This study aimed to describe the epidemiology of prurigo nodularis compared with that of psoriasis. The German sickness fund claims database, with 2,783,175 continuously insured patients, included 1,720 patients diagnosed with prurigo nodularis and 51,390 with psoriasis. Patients with prurigo nodularis were averagely 8 years older than psoriasis patients and more often were women ( p < 0.001). Annual incidence was a constant 0.02% in prurigo nodularis, and decreased steadily from 0.53 to 0.42% in psoriasis; cumulative incidence was 0.1% for prurigo nodularis and 1.9% for psoriasis. Prevalence was 0.1% for prurigo nodularis and 4.7% for psoriasis, with a one-year mortality of 5.4% for prurigo nodularis and 1.2% for psoriasis ( p < 0.001). The most frequent pre-existing comorbidities in patients with prurigo nodularis were inflammatory dermatoses and depression. This epidemiological study found a low prevalence of prurigo nodularis, manifesting different demographics and comorbidities compared with psoriasis.

Objective: The objective of this study was to obtain real-world information on gonadotropin-releasing hormone agonist/antagonist (GnRHa) therapy in patients with advanced prostate cancer (PCa).Materials and methods: Anonymized, routine healthcare claims data from approx. 75 German statutory health insurance funds from 2010–2015 (n = 4,205,227) were analyzed. Patients had an enrolment of 1 year before GnRHa, 1 index quarter of initial GnRHa prescription and ≥2 years of follow-up.Results: In total, 2,382 patients with PCa were eligible. The most frequent index therapy was leuprolide in 56.6%. The rank order of PCa comorbidity prevalence was consistent over time (% at index and 3-years of follow-up): hypertension (71.5; 85.0), hyperlipidemia (45.2; 60.8), cardiovascular disease (CVD) (35.7; 54.1), and diabetes (28.3; 36.2). Comparing pooled therapy classes (agonists, hybrids, and antagonist), no significant differences in the incidence of CVD or diabetes were observed. For hypertension, there was a significant increase for agonists (16.4%) compared to antagonists (6.9%, p = 0.022) and leuprolide hybrid group (11.6%, p = 0.006). During the follow-up period 23.9% of all PCa patients died. There were no significant differences concerning mortality rate and discontinuation rates between the cohorts. In total, 11.2% of all patients discontinued GnRHa after first prescription; the mean time to first switch to another GnRHa therapy was 100 days earlier for hybrids than for agonists (p = 0.016).Conclusion: This comparative retrospective analysis provides real-world information about healthcare characteristics and treatment patterns, highlighting the impact of different GnRHa on clinical outcomes for patients with advanced PCa in Germany.

Purpose Photodynamic diagnosis using hexaminolevulinate (HAL)—guided BL-TURB may reduce the recurrence risk in non-muscle invasive BCa compared to standard WL-TURB due to more sensitive tumor detection. The impact of the initial use of WL- vs. BL-TURB on follow-up costs was evaluated in this real-world data analysis. Methods Anonymous claims data of German statutory health insurances (GKV) from 2011 to 2016 were analyzed in a primary and adjusted study population. Selection criteria included five quarters before enrolment, one index quarter (InQ) of initial TURB and BCa diagnosis, either within two years for the primary analysis or within four years for the adjusted analysis, and a follow-up period (FU) of either eleven or three quarters, respectively. Results In the primary analysis (n = 2331), cystectomy was identified as an important cost driver masking potential differences between cohorts. Therefore, patients undergoing cystectomy (InQ + FU) were excluded from the adjusted study population of n = 4541 patients (WL: 79%; BL: 21%). Mean total costs of BL-TURB were initially comparable to WL-TURB (WL: EUR 4534 vs. BL: EUR 4543) and tended to be lower compared to WL-TURB in the first two quarters of FU. After one year (3rd FU quarter), costs equalized. Considering total FU, mean costs of BL-TURB were significantly lower compared to WL-TURB (WL: EUR 7073 vs BL: EUR 6431; p = 0.045). Conclusion This retrospective analysis of healthcare claims data highlights the comparability of costs between BL-TURB and WL-TURB.

Zusammenfassung Hintergrund Die Androgendeprivationstherapie (ADT) ist fester Therapiebestandteil des fortgeschrittenen oder metastasierten Prostatakarzinoms (PCa). Ziel der vorliegenden Versorgungsforschungsstudie war der Vergleich von Verordnungsmustern, Hospitalisierungsraten und Krankenhauskosten beim initialen Einsatz verschiedener GnRH-Agonisten und -Antagonisten (GnRHa). Material und Methoden Anonymisierte GKV-Daten von > 70 Krankenkassen aus 2010 bis 2015 (n = 4 205 227) wurden analysiert (1 Jahr Vorbeobachtung, 1 Indexquartal mit initialer GnRHa-Verordnung, ≥ 2 Jahre Follow-Up (FU)). Ergebnisse Die Studienpopulation umfasste 2382 PCa-Patienten im Alter von durchschnittlich 75 Jahren. Leuprorelin (Leu) wurde mit 56,6 % am häufigsten verordnet. Bei erstmaliger GnRHa-Anwendung hatten 70 % aller Patienten keine Lymph- oder Fernmetastasen. Nach der initialen Verordnung wurden bei 11,2 % die GnRHa abgesetzt, bei 17,6 % nach durchschnittlich 457 Tagen (Median: 399 Tage) umgestellt, in der Hybrid (Hyb)-Gruppe durchschnittlich 100 Tage schneller als bei den Agonisten (p = 0,016). Die Prävalenzrangfolge der häufigsten Komorbiditäten war über die Zeit gleichbleibend: Hypertonie, Hyperlipidämie, kardiovaskuläre Erkrankungen (CVD) und Diabetes. Die Hypertonieprävalenz zeigte einen signifikant höheren Anstieg unter Agonisten (16,4 %; vs. Antagonist 6,9 % p = 0,022; vs. Hybride 11,6 % p = 0,006). Bei der CVD gab es hinsichtlich der relativen Wachstumsraten zwischen den 3 zusammengefassten Therapieklassen keine signifikanten Unterschiede. Insgesamt waren 23,9 % aller Patienten nach 3 Jahren FU verstorben. Die Mortalitätsrate war am niedrigsten für Triptorelin (Trp, 22,1 %) und am höchsten für Goserelin (Gos, 29,4 %, n.s.). Im Indexquartal hatten 26,4 % der Patienten mind. einen Krankenhausaufenthalt [min; max: Trp 22,4 %; Gos 30,3 %] mit einer mittleren Krankenhausverweildauer/Patient von 3 Tagen [Trp 2,4; Gos 4,5]. Die jährliche Hospitalisierungsrate lag bei 36,2 – 40,7 %, die mittlere Krankenhausverweildauer im gesamten FU zwischen 17,6 (Trp) und 20,8 (Hyb) Tagen. Die Krankenhauskosten im Indexquartal betrugen ca. 1200 EUR [Trp 988; Gos 1803] und pro FU-Jahr ca. 3000 EUR. In der Trp-Kohorte lagen die Gesamtkosten (Indexquartal + 3 Jahre) mehr als 1000 EUR unter dem Durchschnitt von 9476 EUR [Trp 8116; Leu 9779; n.s.]. Schlussfolgerung Diese GKV-Versorgungsforschungsstudie beschreibt die Anwendung von GnRHa zur initialen Therapie beim fortgeschrittenen PCa in Deutschland und zeigt substanzabhängige Unterschiede in den Verordnungsmustern, Hospitalisierungsraten und Krankenhauskosten.

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