Health-Related Quality of Life in Moderate-to-Severe Plaque Psoriasis Patients in Brazil

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Mosqueira NR Knowlege and Development, Lima, Peru

Objectives: Estimar la elasticidad precio de la demanda de bebidas azucaradas y agua embotellada.  Methods: Estudio de corte transversal de los patrones de consumo de bebidas azucaradas y agua embotellada a nivel de hogares y estimación econométrica del Sistema Casi Ideal de Demanda Cuadrático (QUAIDS, por sus siglas en inglés) utilizando datos de la Encuesta Nacional de Hogares (ENAHO) 2011-2015 para una muestra de 79,941 hogares en el país usando STATA 14 (Poi, 2012).  Results: La participación en el gasto del hogar del grupo Alimentos y Bebidas es 40%, mientras que el sub-grupo Bebidas corresponde a 1.2%. En términos absolutos, el gasto per-cápita año de gaseosa es US$ 15.5 (DS= 18.2) el año 2011, pasando a US$14.4 (DS= 16.5) el año 2015. La cantidad demanda de gaseosas, ha pasado de 18.8 lt. a 16 lt persona-año entre 2011 y 2015; en cambio, el Agua el nivel de consumo fue 28.8 lt pasando a 33.6 entre 2011 y 2015. La elasticidad precio de la gaseosa es elástica e igual a 1.6, ante un incremento de 10% en el precio, se esperaría una reducción del consumo en 16%. La elasticidad precio del agua es 1.5. Estos resultados son similares a los hayados en México. (M.A. Colchero, 2015a), las cuales resultan siendo elásticas en ambos estudios.  Conclusions: Los niveles estimados de elasticidad precio de las bebidas gaseosas, auguran que un impuesto al consumo de éstos productos, desincentivaran su consumo, no obstante, el patrón de consumo de bebidas gaseosas en el Perú es menos importante que en México. PSY45 Tratamento Clínico De Obesidade Através De Internações Clínicas Em Spa: Impacto Econômico Da Judicialização Moraes Z, Castro AP, Pegoretti Rosa B Evidencias - Kantar Health, Campinas, Brazil

Objectives: analisar o impacto econômico para operadoras de saúde das liminares autorizando internação clínica em SPA para o tratamento de obesidade.  Methods: dados demográficos e clínicos foram extraídos, de maneira anônima, do Módulo de Avaliações Jurídicas (MAJ) do banco de dados Evidencias-Kantar Health, que cobre 34 operadoras de saúde e 3,5 milhões de vidas em todo o Brasil. O MAJ permite a avaliação online de demandas judiciais/liminares recebidas pelas operadoras. Dados sobre o custo médio da diária de internação foram obtido diretamente através de contatos telefônicos com diversos spas. Nenhuma das internações foi recomendada por motivos técnicos, mas foram ordenadas através das liminares.  Results: Entre novembro de 2013 e março de 2017, 1109 guias de casos jurídicos foram inseridos no MAJ. Destas, 53 (4,77%) eram referentes pacientes com diagnóstico referido de obesidade mórbida para os quais foi ordenada judicialmente a internação em spa. Dos 53 pacientes, 30 eram homens e 23 mulheres, com idade média de 47,41 anos (11 a 80) e índice de massa corporal (IMC) médio de 42,35 kg/m2 (30,73 a 59). Exceto por um caso, todos os outros pacientes eram segurados pela mesma operadora de saúde que cobre 258,5 mil vidas em todo o país. Apesar do alcance nacional, todas as liminares foram solicitadas pela mesma clínica no Nordeste do país. Das 53 guias, 50 informaram o número de diárias de internação solicitadas (n= 7230). Em média foram solicitadas 144,6 dias (120-150 dias) de internação em spa por cliente a um custo unitário de R$ 561,60/dia, totalizando um valor de R$ 4.060.368,00 em gastos para as operadoras de saúde.  Conclusions: um único centro de tratamento é responsável por quase 5% das liminares inseridas no MAJ. A judicialização deste tipo de caso gerou um gasto de mais de 4 milhões de reais para as operadoras envolvidas, sem benefício comprovado para os pacientes. PSY46 Appropriate Ankylosing Spondylitis (AS) Treatment is Delayed For Years: Results From a Multi-National Survey Including Latin America Pinheiro M1, Strand V2, Alten R3, Conaghan PG4, Sullivan E5, Blackburn S5, Tian H6, Gandhi K6, Jugl SM7, Deodhar A8 1Federal University of Sao Paulo (Unifesp/ EPM), Sao Paulo, Brazil, 2Stanford University, Stanford, CA, USA, 3Schlosspark-Klinik, University Medicine Berlin, Berlin, Germany, 4University of Leeds, Leeds, UK, 5Adelphi Real World, Bollington, UK, 6Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, 7Novartis Pharma AG, Basel, Switzerland, 8Oregon Health & Science University, Portland, OR, USA

Objectives: To describe the diagnosis and treatment pathway of patients with AS.  Methods: Rheumatologists from 18 countries, including Brazil and Mexico (LatAm), and their AS patients were surveyed. Rheumatologists provided information on patients demographics, disease and treatment history; patients voluntarily provided demographics and disease history.  Results: 641 Rheumatologists (LatAm: 31) included 2,887 patients (LatAm: 139). On average AS diagnosis occurred 3.0 years (SD:5.5) after symptom onset (LatAm: 2.8years; SD: 5.8). After this long period without specific AS treatment, at diagnosis only 71.7% received conventional therapy (Non-Steroidal Anti-Inflammatory Drug with or without conventional systemic Disease Modifying Anti Rheumatic Drug (csDMARD)); 9.0% received biologic therapy, 19.3% were not started on any pharmaceutical treatment included the ASAS AS recommendations despite being symptomatic (LatAm: 66.2%, 9.4%, 24.5% respectively). These patients without treatment initiation at diagnosis (n= 531; LatAm: 36) waited on average an additional 4.1years (LatAm: 3.7years) before their first pharmaceutical treatment was initiated. Almost half the patients received csDMARDs (45.7% LatAm: 57.6%), of whom 42.9% (LatAm: 20%) had purely axial disease where there is a known lack of efficacy of csDMARDs . Of patients currently receiving a biologic, almost half (46.4% LatAm:55.6%) received at least 1 csDMARD before the biologic, 27.1% 1 csDMARD; 15.6% 2 csDMARDS; 3.7% > 3 csDMARDs (LatAm: 32.3%, 19.4% 4.0% respectively). Patients who receive > 1 csDMARD before biologic waited longer before biologic therapy was initiated (3.3 vs. 2.4 years, p= 0.0001; LatAm: 2.2 vs. 1.1 years, p= 0.0007).  Conclusions: The analysis suggests there are opportunities to greatly improve AS treatment patterns: 1) by reducing the years that AS patients have to wait until confirmed diagnosis; 2) ensuring all patients receive effective treatment for AS immediately at the point of diagnosis; 3) by carefully assessing the use of csDMARDs in axial disease which seem to delay more effective biologic therapy initiation.

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PSY47 Appropriate Psoriatic Arthritis Treatment is Delayed for Years: Results From a Multi-National Survey Including Latin America Azevedo VF1, Conaghan PG2, Strand V3, Sullivan E4, Blackburn S4, Tian H5, Gandhi K5, Jugl SM6, Alten R7 1Federal University of Paraná, Curitiba, Brazil, 2University of Leeds, Leeds, UK, 3Stanford University, Stanford, CA, USA, 4Adelphi Real World, Bollington, UK, 5Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, 6Novartis Pharma AG, Basel, Switzerland, 7Schlosspark-Klinik, University Medicine Berlin, Berlin, Germany

Objectives: To describe the diagnosis and treatment timeline and pathway of patients with PsA.  Methods: Specialists (Rheumatologists, Dermatologists) from Latin America (Brazil and Mexico; LatAm), North America, Europe, Asia Pacific, and the Middle East, and their PsA patients were surveyed. Specialists provided information about patient demographics, disease and treatment history; patients voluntarily provided demographics and disease history.  Results: 952 Specialists (LatAm: 85) included 3,782 patients (LatAm: 292), 51.6% (LatAm: 50.7%) of whom were male. 67.7% of PsA patients (LatAm: 58.0%) had a psoriasis diagnosis before PsA, of whom only 41.1% (LatAm: 50.0%) were known to have been screened/monitored for PsA symptoms before their PsA diagnosis. On average across all PsA patients diagnosis occurred 1.6 years (SD: 3.8) after PsA symptom onset (LatAm: 1.8 years; SD: 2.8). After this extended duration without specific PsA treatment, at diagnosis 5.1% of patients received topical or phototherapy only, 68.3% of patients received conventional therapy (Non-Steroidal Anti-Inflammatory Drugs, or conventional synthetic Disease Modifying Anti Rheumatic Drugs (csDMARD) or systemic corticosteroid); 10.4% received advanced therapy (AT; biologic or phosphodiesterase-4 inhibitor), and 16.1% were not initiated treatment included in the GRAPPA recommendations despite being symptomatic (LatAm: 6.8%, 56.8%, 21.9%, 14.4% respectively). Patients without treatment initiation at diagnosis (n= 723; LatAm: n= 122) waited on average an additional 2.8years (LatAm: 2.7years) before their first pharmaceutical treatment was initiated. Of the patients currently receiving AT (n= 2246; LatAm: n= 227), 28.9% received no csDMARD before AT, 37.6% received 1 csDMARD, 24.7% 2, and 8.9% > 3 (LatAm: 22.5%, 44.1%, 28.6%, 4.8% respectively).  Conclusions: The analysis suggests there are opportunities to improve PsA treatment patterns by reducing the years that PsA patients often have to wait until confirmed diagnosis, potentially through increased screening among psoriasis patients, and ensuring all patients receive effective treatment for PsA immediately at the time of diagnosis. PSY48 Tasas De Hospitalización De Los Pacientes Con Defectos De La Coagulación (Demanda Y Profilaxis) EN UNA Aseguradora Colombiana Romero Prada ME1, Roa Cardenas NC2, Huerfano LM1, Cruz AM3, Barrios E4, Marino C5 1Fundación Salutia, Bogotá, Colombia, 2Salutia Foundation - Research center in economy, management and health technologies., Bogota, Colombia, 3Coomeva EPS, Cali, Colombia, 4Coomeva Group, Cali, Colombia, 5Coomeva, Bogotá, Colombia

Objectives: Evaluar las tasas de hospitalización que presentan los pacientes con defectos de la coagulación y se encuentran en tratamiento a demanda o profiláctico en una aseguradora colombiana.  Methods: Se consultaron en bases de datos de una aseguradora colombiana, los registros de un año de hospitalizaciones de pacientes que presentaban cualquier tipo de defecto de la coagulación para identificar el número de hospitalizaciones presentadas y el costo que estas le generaban al sistema de salud, se analizaron las diferencias por tipo de tratamiento a demanda y profilaxis.  Results: De un total de 320 pacientes con trastorno de coagulación 71 pacientes registraron al menos un episodio de hospitalización en el año de análisis. De los pacientes identificados en programa de tratamiento a demanda la tasa anual fue de 46.43 % de pacientes con al menos un evento de hospitalización y del 54.88 % para los que estan en un programa de tratamiento en profilaxis. Al analizar los pacientes con eventos, la media de eventos fue de 4,27 siendo mayor en el grupo a demanda.  Conclusions: Del análisis realizado se concluyó que los pacientes con defectos de la coagulación que están en esquema de tratamiento a demanda presentan una efectividad superior a la esperada de acuerdo a la literatura consultada mientras que los pacientes en esquema de tratamiento profiláctico presentan una mayor tasa de hospitalización.

SYSTEMIC DISORDERS/CONDITIONS – Patient-Reported Outcomes & Patient Preference Studies PSY33 Health-Related Quality of Life in Moderate-to-Severe Plaque Psoriasis Patients in Brazil Lopes N1, Gontijo B2, Romiti R3, Santana PK4, Machado P1 Biociências SA, Sao Paulo, Brazil, 2Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil, 3Hospital das Clínicas University of São Paulo (USP), São Paulo, Brazil, 4Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil 1Novartis

Objectives: To assess the impact of moderate-to-severe plaque psoriasis on patient health-related quality of life (HRQoL). Methods: This was a crosssectional, observational and multicenter study enrolling Brazilian patients with moderate-to-severe plaque psoriasis. Data were collected between December/2015 and November/2016 in 10 specialized centers. Severity was defined according to physician evaluation. Data regarding HRQoL were obtained through two instruments: EuroQol-5D questionnaire (EQ-5D-3L) and Dermatology Life Quality Index questionnaire (DLQI). EQ-5D-3L also includes a Visual Analogue Scale (EQ-VAS), which ranges from 0 (worst imaginable health state) to 100 (best imaginable health state).  Results: The study included 188 patients. Most of them were female (52.1%), Caucasian/white (68.6%) and married/stable union (61.7%). The mean age at study visit and at disease onset were 48 (±13.1) and 33 (±16) years, respectively. The leading comorbidities were hypertension (46.2%), dyslipidemia (39.3%) and

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psoriatic arthritis (31.0%). All patients answered DLQI and 176 (93.6%) provided valid responses for EQ-5D-3L. The mean DLQI score was 7.2 (±6.8). According to the DLQI categories, disease had no effect at all in 26.6% patients, small effect in 22.9%, moderate effect in 23.4%, very large effect in 20.7% and extremely large effect in 6.4%. The highest effect was found for “symptoms and feelings” domain (Mean 2.4 ±1.7) and the lowest in “work and school” domain (Mean 0.4 ±0.8). The EQ-5D index was 0.70 (±0.27). The dimensions “anxiety and depression” and “pain and discomfort” presented the highest quality of life impairment, in which 14.2% and 5.7% of patients reported to have extreme problems and 46.6% and 49.4% some problems, respectively. “Self-care” was the least affected dimension, with 88.1% of responders reporting absence of problems. Overall score of EQ-VAS was 68.7 (±22.3).  Conclusions: Moderate-to-severe psoriasis negatively affects Brazilian patients’ HRQoL, especially in terms of anxiety and depression as well as pain and discomfort. PSY34 Work Productivity in Brazilian Patients with Moderate-to-Severe Plaque Psoriasis Lopes N1, Antonio JR2, Fabricio L3, Azulay-Abulafia L4, Dias LL5, Pertel P6 Biociências SA, Sao Paulo, Brazil, 2Fundação Faculdade Regional de Medicina de São José do Rio Preto, Sao Jose do Rio Preto, Brazil, 3Hospital Universitário Evangélico de Curitiba, Curitiba, Brazil, 4Instituto de Dermatologia e Estética do Rio de Janeiro (IDERJ), Rio de Janeiro, Brazil, 5ANOVA, Rio de Janeiro, Brazil, 6Novartis Biociencias SA, Sao Paulo, Brazil

1Novartis

Objectives: To describe work productivity among Brazilian patients with moderate-to-severe plaque psoriasis.  Methods: A cross-sectional, observational and multicenter study enrolling Brazilian patients with moderate-to-severe plaque psoriasis. Disease severity was defined according to physician evaluation. Data collection occurred between December/2015 and November/2016 in 10 specialized centers. Work productivity was assessed by using the Work Productivity and Activity Impairment Questionnaire – General Health (WPAI-GH) and the Work Limitations Questionnaire (WLQ). WPAI-GH assess the impact of disease on productivity in the past seven days through the following domains: absenteeism, presenteeism, percentage of overall work impairment and percentage of daily activity impairment due to health. WLQ focuses on presenteeism through the proportion of work-time with limitation due to health in the past two weeks, considering the following dimensions: physical demands, time management, mental-interpersonal demands, and output demands. Scale scores range from 0 to 100. A total WLQ index score can be calculated and converted into an estimate of productivity loss. It indicates the % difference in output from a healthy population.  Results: The study included 188 patients, 52.1% female, mean age of 48 (±13.1) years. Most of patients were Caucasian/white (68.6%), married/stable union (61.7%) and 59.6% currently had professional activity. According to WPAI-GH (N= 188), the most affected dimension was daily activity (mean:25.7%; ±29.5%) and presenteeism was higher than absenteeism (mean:17.4%; ±25.5% vs. mean:6.3%; ±13.8%). The overall work impairment was the least affected domain (mean 5.4%; ±10.3%). For WLQ (N= 112), physical demand was the most affected scale (mean:23.5; ±28.5), followed by time demand (mean 17.7; ±24.9), mental-interpersonal demands (mean:16.6; ±22.4) and output demands (mean:14.8; ±22.4). The mean WLQ index was 4.7 (±5.4).  Conclusions: Moderate-to-severe plaque psoriasis negatively affects daily activities and work productivity in Brazilian patients. Patients in this study should increase approximately 5% in work hours to compensate (compared to healthy) for productivity loss. PSY35 Treatment Satisfaction Among Patients with Moderate-to-Severe Plaque Psoriasis in Brazil Lopes N1, Suarez R M2, Sabbag CY3, Kobata CM4, Takemoto MS5, Pertel P6 Biociências SA, Sao Paulo, Brazil, 2Hospital do Servidor Público Municipal, Sao Paulo, Brazil, 3Centro Paulista de Investigação Clínica e Serviços (CEPIC), Sao Paulo, Brazil, 4Santa Casa de Misericórdia de São Paulo, Sao Paulo, Brazil, 5ANOVA, Rio de Janeiro, Brazil, 6Novartis Biociencias SA, Sao Paulo, Brazil .

1Novartis

Objectives: To explore the satisfaction with any performed treatment among patients with moderate-to-severe plaque psoriasis in Brazil.  Methods: A crosssectional study enrolling Brazilian patients with moderate-to-severe plaque psoriasis in 10 centers specialized in the treatment of the disease was conducted between December/2015 and November/2016. During a face-to-face structured interview, patients answered questions about demographic and clinical characteristics. To assess satisfaction with treatment, the 14-item Treatment Satisfaction Questionnaire for Medication (TSQM) was used. This instrument provides scores on four scales – side effects, effectiveness, convenience and global satisfaction – that ranges from 0-100, in which higher scores represent more satisfaction. Data was analyzed using measures of central tendency and dispersion and measures of frequency.  Results: 188 patients were included in the study. Most patients were female (52.1%) and Caucasian/white (68.6%). Mean age at study visit and at disease onset were 48 (±13.1) and 33 (±16) years, respectively. The leading comorbidities were hypertension (46.2%), dyslipidemia (39.3%) and psoriatic arthritis (31.0%). Regarding the treatment, 71.8% reported to have taken at least 1 oral or injectable medication, 95.2% topical medication and 22.3% phototherapy in a period of one year before the interview. One hundred and eighty four (184/ 188–98.9%) patients were included in TSQM analysis. Patients reported the highest score in the domain of side-effects (Mean 88.7 ±20.0) and the lowest score in the domain of effectiveness (Mean 58.4 ±24.7), implying that they were not satisfied with the effectiveness of their medications. Mean scores of 68.9 (±18.3) and 64.2 (±24.9) were observed for the domains convenience and global satisfaction, respectively.  Conclusions: Although the patients that were included in the present analysis belong to reference centers to psoriasis treatment, they were not satisfied with current treatment effectiveness. These findings showed a clear need for new, safe and more effective treatments for moderate to severe psoriasis patients.

PSY36 Ixekizumab Treatment Leads to Early Resolution of Bothersome Symptoms Versus Ustekinumab Burge RT1, Papadimitropoulos M2, Henneges C3, Garcia EG4, Romiti R5 Lilly and Company, Indianapolis, IN, USA, 2Eli Lilly and Company, Canada, Toronto, ON, Canada, 3Eli Lilly and Company, Bad Homburg, Germany, 4Eli Lilly and Company, Mexico City, Mexico, 5Hospital das Clínicas University of São Paulo (USP), São Paulo, Brazil

1Eli

Objectives: Ixekizumab (IXE) is a high-affinity monoclonal antibody that selectively targets interleukin-17A and has demonstrated superiority to ustekinumab (UST) at 12 weeks. Bothersome symptoms through 24 weeks are presented.  Methods: In this trial (IXORA-S, NCT02561806), patients were randomized (1:1) to receive either IXE (160-mg starting dose, then 80-mg every 2 weeks for 12 weeks followed by 80-mg every 4 weeks; N= 136) or UST (45-mg/90-mg weight-based dosing per label; N= 166). At Week 12 and 24, categorical data were assessed using non-responder imputation (NRI). Itch and skin pain were measured using a 0-10 numeric rating scale (0= no itch, 10= worst itch imaginable) and 100mm visual analog scale (VAS) (0= no pain; 100 worst pain imaginable) in previous 24 hours, respectively. The proportions reaching 0 for itch and skin pain between treatment groups at each time point (except week 12 and week 24) were compared using Fisher’s Exact test (NRI).  Results: At baseline, 2.2% of IXE-treated and 2.4% of UST-treated patients reported no itching; and no skin pain for 8.8% of IXE and 12% of UST patients was reported. At weeks 4, 8 and 16, statistically, significantly greater proportions of IXEtreated patients vs. UST patients achieved complete reduction in itching. By week 24, the proportions of IXE vs. UST patients who indicated no itching were 46.3% vs. 33.7% (p= 0.051). For skin pain, at weeks 2, 4, 8 and 16, statistically significantly greater proportions of IXE patients reported no skin pain compared to UST patients; while by week 24 the proportions of patients indicating no pain were 48.5% (IXE) vs. 36.1% (UST) (p= 0.051).  Conclusions: Psoriasis symptoms of itching and skin pain were resolved early with IXE treatment compared to UST, while the proportions with complete resolution between treatments converged by week 24. PSY37 Ixekizumab Treatment Leads to Early Improvements in HealthRelated Quality of Life Versus Ustekinumab Burge RT1, Papadimitropoulos M2, Henneges C3, Garcia EG4, Romiti R5 Lilly and Company, Indianapolis, IN, USA, 2Eli Lilly and Company, Canada, Toronto, ON, Canada, 3Eli Lilly and Company, Bad Homburg, Germany, 4Eli Lilly and Company, Mexico City, Mexico, 5Hospital das Clínicas University of São Paulo (USP), São Paulo, Brazil

1Eli

Objectives: Ixekizumab (IXE) is a high-affinity monoclonal antibody that selectively targets interleukin-17A and superiority to ustekinumab (UST) at 12 weeks has been shown. Health-related quality of life (HRQoL) results through 24 weeks are presented.  Methods: In the IXORA-S trial (NCT02561806), patients were randomized (1:1) to receive either IXE (160-mg starting dose, then 80-mg every 2 weeks for 12 weeks followed by 80-mg every 4 weeks; N= 136) or UST (45-mg/90-mg weightbased dosing per label; N= 166). At Weeks 2, 4, 12, and 24, HRQoL was assessed by the Dermatology Life Quality Index (DLQI)—which has 10 items and 6 domains (symptoms & feelings [SF], daily activities [DA]; leisure; work & school [WS]; personal relationships [PR]; treatment); total scores range 0−30; higher scores indicate worse HRQoL—and by SF-36 physical component summary (PCS) and mental component summary (MCS) [higher SF-36 scores indicate better HRQoL]. Changes from baseline between groups were analyzed using ANCOVA with terms for baseline, treatment, weight and geographic region (weeks 12, 24), and Wilcoxon rank sum test (weeks 2, 4) with modified baseline observation carried-forward.  Results: Mean (SD) DLQI baseline scores were 11.1 (7.18) and 12.0 (7.28) for IXE and UST patients, respectively. At all time-points (except week 24), IXE patients had statistically significantly lower total DLQI scores compared to UST; and fell (improved) to 2.0 (3.73) and 3.0 (4.23) for IXE and UST (p= 0.071) at Week 24. For DLQI domains, IXE patients showed statistically significant improvements vs. UST at week 2 (SF, DA, leisure, WS) and week 4 (SF, DA). SF-36 PCS changes from baseline were significantly greater for IXE vs. UST at week 12 (5.8 vs. 3.2, p= 0.033) and week 24 (6.2 vs. 3.8, p= 0.014).  Conclusions: Improvements in four DLQI domains were superior early, and at weeks 12 and 24 for SF-36 PCS, with IXE treatment compared to UST. PSY38 Epidemiology of Physician-Diagnosed Neuropathic Pain in Brazil Udall M1, Kudel I2, Cappelleri JC3, Sadosky A1, Concialdi K2, Parsons B1, Hlavacek P1, Hopps M1, Salomon P4, DiBonaventura M5, Clark P6, Garcia JB7 1Pfizer Inc., New York, NY, USA, 2Kantar Health, New York, NY, USA, 3Pfizer Inc., Groton, CT, USA, 4Pfizer Inc., Bosques de las Lomas, Mexico, 5Ipsos Healthcare, New York, NY, USA, 6Hospital Infanti de México, Cuauhtémoc, Mexico, 7University of Maranhão, São Luís, Brazil

Objectives: Estimate the prevalence of neuropathic pain (NeP) among chronic pain patients attending Brazilian hospitals and pain clinics in São Paulo, Ceara, and Bahia and explore the clinical characteristics of six principal subtypes.  Methods: Physicians used Douleur Neuropathique-4 and exam to diagnose NeP in patients reporting chronic pain for ≥ 3 months (n= 2,118). They also reported NeP subtype(s) and symptoms. Diagnosed patients completed a questionnaire that included treatment experiences, the EuroQoL-5D-3L (EQ-5D), Brief Pain Inventory (BPI), and the Work Productivity and Activity Impairment questionnaire. Descriptive analyses were performed.  Results: NeP prevalence was 14.5% (n= 307). Patients were mostly female (80.5%), middle-aged (Mean= 52.5, Standard Deviation= 13.9), and Pardo ethnicity (44.3%). Of those diagnosed with a NeP subtype (n= 206), the largest proportion were diagnosed with chronic low back pain with a neuropathic component (36.8%). Others were diagnosed with diabetic peripheral (DPN; 18.7%), central neuropathic pain (CNP; 17.7%), post-trauma neuropathy (PTN; 17.2%), followed by post-surgical neuropathy (PSN; 13.4%), and post-herpetic neuralgia (PHN; 3.3%). The most widely reported symptoms across subtypes were numbness (62.2%-88.9%) and hyperalgesia (32.1%-75.0%). The most widely used pain analgesics across subtypes were nonsteroidal anti-inflammatory drugs (NSAID; 14.3%-47.2%) and opioids (0.0%-35.7%). PTN and PSN patients reported the lowest EQ-5D index scores (M= 0.42, SD= 0.19)