Prevalence of Eosinophilic Granulomatosis With Polyangiitis and Associated Health Care Utilization Among Patients With Concomitant Asthma in US Commercial Claims Database

Abstract

Objective To estimate the prevalence and associated disease burden of eosinophilic granulomatosis with polyangiitis (EGPA) in patients with asthma from a US claims database. Methods Two cohorts were defined using enrollees (aged ≥18 years) from the Optum deidentified Clinformatics Datamart claims database 2010–2014, based on validated EGPA case definitions with varying specificity: EGPA 1 (main cohort; more specific; patients with 2 codes [in any combination] within 12 months of each other for eosinophilia, vasculitis, or mononeuritis multiplex) and EGPA 2 (sensitivity analysis cohort; less specific; patients with 2 codes of above conditions and/or neurologic symptoms within 12 months of each other). Patients had 3 or more asthma medications in the 12-month baseline before index date (date of the second code). Eosinophilic granulomatosis with polyangiitis prevalence, asthma severity during the baseline period, oral corticosteroid (OCS) use, and health care utilization during the 12-month follow-up period were determined. Results Overall, 88 and 604 patients were included in main cohort EGPA 1 and sensitivity analysis cohort EGPA 2, respectively; corresponding annual EGPA prevalence rates were 3.2 to 5.9 and 23.4 to 30.7 cases/million patients. Approximately 75% of patients were prescribed OCS and ~30% experienced 1 or more hospitalization; 75% in EGPA 1 and 52% in EGPA 2 with 1 or more non-OCS prescription in the 90 days before index date had severe asthma. Conclusions Eosinophilic granulomatosis with polyangiitis prevalence estimates varied based on specificity of the case definition but were generally consistent with previous country-specific estimates. Despite differences in prevalence, both cohorts displayed a generally similar, high burden of OCS use and health care utilization, highlighting the substantial disease burden among patients with EGPA and the need for specific treatments.

Burden of illness associated with eosinophilic granulomatosis with polyangiitis: a systematic literature review and meta-analysis

“…It was therefore not feasible to reliably evaluate potential trends in incidence or prevalence. A large real-world database study published after the time period of this systematic literature review has shown that in the USA, EGPA is more common in females than in males and more frequently reported in individuals over 50 years of age [ 13 ].…”

Burden of illness and costs associated with eosinophilic granulomatosis with polyangiitis: evidence from a managed care database in the United States

“…[10][11][12] However, a specific diagnosis code for use in identifying patients with EGPA from health records was only established in the United States in October 2015 with the adoption of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM); before ICD-10-CM, studies evaluating the burden of EGPA via retrospective analyses of administrative claims data relied on a series of coding algorithms (eg, International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] diagnosis and procedures codes, Current Procedural Terminology [CPT] codes, and physician specialties). [13][14][15][16][17][18] Owing to the previous lack of EGPA-specific diagnosis codes and limited number of regulatory approved treatments, data are limited on the clinical and economic burden of EGPA. Comparing clinical outcomes in EGPA with those in patients with asthma, in which the disease burden is well established, 19 is a useful way to measure the burden of EGPA for patients and payers.…”

From DREAM to REALITI‐A and beyond: Mepolizumab for the treatment of eosinophil‐driven diseases

“…Historically, conventional treatment was with OCS, with or without additional immunosuppressive drugs, 59 but many patients experienced corticosteroid‐related side effects or relapses during OCS tapering 60 . As a result, healthcare resource utilization and burden of disease and treatment were high 61 …”

“…60 As a result, healthcare resource utilization and burden of disease and treatment were high. 61 Since eosinophils contribute to the pathophysiology of EGPA, and with severe eosinophilic asthma being a key feature of the disease, 57 mepolizumab was postulated as a potential treatment option for patients with EGPA. In 2010, early data on the use of mepolizumab in patients with EGPA were published in a case report and in a pilot trial.…”