Real-World Treatment Patterns Among Newly Diagnosed Patients With Plantar Fibromatosis in the United States.

Abstract

Plantar fibromatosis (PFI) is a rare condition that affects the plantar aponeurosis resulting in painful nodules on the foot/feet. There are no clinical guidelines for treatment in the United States, and real-world evidence regarding treatment patterns is limited. This retrospective cohort study used linked data from adjudicated claims and electronic medical records to identify patients with incident PFI. PFI prevalence in 2021 was estimated, and treatment patterns for conservative (nonsurgical) and surgical interventions were assessed during the 24 months after diagnosis. Age- and sex-adjusted PFI prevalence was 57.03 cases per 100,000 in 2021. In the incident PFI cohort (N=620), 392 patients (63.23%) were female. During the 12-month baseline period before diagnosis, 19.03% of patients had evidence of foot/ankle pain or stiffness, and 53.55% received prescribed analgesics or steroids. Most patients (91.13%) received conservative treatment during follow-up, including injectable corticosteroids (59.19%), oral corticosteroids (44.68%), and physical/occupational therapy (PT/OT, 40.81%). On average, treated patients had 2.10 oral and 2.63 injectable steroid claims and 15.8 PT/OT visits during follow-up. Surgical interventions were rarely used (n=42; 6.77%); excision of foot tumor (n=15/42; 35.71%) was the most common surgical procedure. Following surgery, conservative treatments were commonly observed (n=39; 92.86%). Our findings suggest patients newly diagnosed with PFI typically received conservative treatments. Although surgery is infrequent, conservative treatments often continue after surgery, which may suggest disease recurrence or persistent symptoms. Additional studies are warranted to develop an understanding of long-term clinical and patient-reported outcomes with/without treatment, among patients with refractory disease.