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. 2018 Dec 5:2018:1292-1299.
eCollection 2018.

Retrospective analysis of health claims to evaluate pharmacotherapies with potential for repurposing: Association of bupropion and stimulant use disorder remission

Emily R Hankosky  1 , Heather M Bush  1 , Linda P Dwoskin  1 , Daniel R Harris  1 , Darren W Henderson  1 , Guo-Qiang Zhang  1 , Patricia R Freeman  1 , Jeffery C Talbert  1
Affiliations

Retrospective analysis of health claims to evaluate pharmacotherapies with potential for repurposing: Association of bupropion and stimulant use disorder remission

Emily R Hankosky et al. AMIA Annu Symp Proc. .

Abstract

Drug repurposing is the identification of novel indication(s) for existing medications. Health claims data provide a burgeoning resource to evaluate pharmacotherapies with repurposing potential. To demonstrate a workflow for drug repurposing using claims data, we assessed the association between prescription of bupropion and stimulant use disorder (StUD) remission. Using the Truven Marketscan database, 96,156 individuals with a StUD were identified. Logistic regression was used to model the association between new bupropion prescriptions and remission while controlling for age, sex, region, StUD severity, antidepressant co-prescriptions, and comorbid mood and attention disorders. Prescription of bupropion within 30 days offirst documented StUD diagnosis increased odds of a subsequent remission diagnosis by 2.1 times (99% confidence interval: 1.09-3.89) in individuals with an amphetamine use disorder, but not those with a cocaine use disorder. This work provides a framework for reverse-translational drug repurposing, which may be applied to many other medical conditions.

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Figures

Figure 1.
Figure 1.
Integration of data-driven repurposing into translational science cycle.
Figure 2.
Figure 2.
Workflow for reverse-translational medication repurposing using health claims data. Reverse-translational repurposing begins with sample and candidate medications identification, followed by selection of medications for retrospective analysis. Findings should then be validated in a broader multimodal and multidisciplinary context.
Figure 3.
Figure 3.
Top 5 most prescribed medications. Number of enrollees with a StUD meeting threshold ≥ 80% PDC (proportion of days covered) up to 180 and 540 days from medication initiation for medication classes (Panel A) and specific medications (Panel B), respectively. Medication classes in Panels A and B are represented by symbols (e.g., antidepressants are circles).
See this image and copyright information in PMC

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