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Mario JNM Ouwens,1 Stefan GAJ Driessen,1 Suntje Sander-Struckmeier2 1Biometrics, Abbott Healthcare Products B.V., Weesp, The Netherlands; 2Gastroenterology/Hepatology, Abbott Laboratories, Hannover, Germany Background: S-adenosylmethionine (AdoMet) is available for the treatment of intrahepatic cholestasis in different doses and in different administration forms. The aim of this study was to develop a categorization model, also called a nomogram, to discern if there was a relationship between prescribers’ treatment preferences and patient baseline characteristics for the treatment options, and to assess whether effectiveness was positively correlated with prescriber preference.Materials and methods: Baseline characteristics of patients in a post-marketing observational study (PMOS) were analyzed by multinomial logistic regression to produce preference probabilities for the prescription of different AdoMet starting regimens: 400 mg injection, 800 mg injection, and 800 mg oral tablets. Grid-optimization based on the preference probabilities was used to subdivide the patients into seven relative treatment preference categories. Subsequently, for each category, the effectiveness of the three treatments was assessed by determining the response rate after 2 weeks of treatment for each treatment group.Results: Elevated total bilirubin values, high Child–Pugh scores, and symptomatic cholestasis were associated with prescriber preference for the 800mg injection, whereas low total bilirubin and low Child–Pugh scores were related to prescriber preference for the 400mg injection. Inthe absence of cholestatic symptoms, the 800mg tablet starting regimen was preferred. In the category where the baseline characteristics did not come to a more- or less-preferred treatment, the response rates were highest for the 800 mg tablets group (67%) and lowest in the 400 mg injection group (50%); however, the total sample size in this category was small (N = 22). Conclusion: Categorization of patients into treatment preference groups based on baseline data might be an interesting approach to assess the validity of the treatment preference versus the respective treatment effectiveness as shown in a PMOS with three AdoMet treatment regimens. Keywords: S-adenosylmethionine, intrahepatic cholestasis, multinomial logistic regression, propensity scores, grid optimization, prescriber preference |
