嗜酸性粒细胞增多性多血管炎患者的疾病重叠、医疗资源利用和成本：REVEAL子研究

IF 2.9 3区医学 Q2 RHEUMATOLOGY

Rheumatology and Therapy Pub Date : 2024-12-01 Epub Date: 2024-10-24 DOI:10.1007/s40744-024-00714-w

Xiao Xu, Christopher Edmonds, YongJin Kim, Michael Stokes, Heide A Stirnadel-Farrant, Justin Kwiatek, Rohit Katial

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In this sub-study, eligibility criteria included an age of ≥ 12 years, ≥ 1 EAD, continuous health-plan eligibility, and compliance with the EGPA/GPA case definition per International Classification of Diseases Ninth/Tenth Revision diagnostic codes between 1 January 2015 and 30 June 2018. Patients were grouped based on whether they had received immunomodulators/cyclophosphamide/mepolizumab (ICM) or not (non-ICM).Results: Of 701 patients with EGPA, 29.5% were in the ICM group. Overall, 72.2% had ≥ 1 overlapping EAD. The number of overlaps was similar for the ICM and non-ICM groups. In patients with blood eosinophil counts ≥ 300 cells/µL, 22.8% had ≥ 1 overlapping EAD. The mean annual all-cause cost was $98,644, 54.1% of which was from outpatients and 33.6% from inpatients. The mean annual EAD- and EGPA-related costs were $23,820 and $9,306, respectively. 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引用次数: 0

摘要

导言：嗜酸性粒细胞肉芽肿伴多血管炎（EGPA）是一种以中小型血管炎症为特征的嗜酸性粒细胞相关疾病（EAD）。在 "世界嗜酸性粒细胞相关疾病重叠调查"（REVEAL）研究中，对 11 种 EAD 之间的重叠进行了评估。在本子研究中，我们评估了 EGPA 与其他 EAD 的重叠情况、全因 EAD 和 EGPA 相关的医疗资源利用率（HCRU）和成本，以及它们与血嗜酸性粒细胞计数和所接受治疗的关系：REVEAL是一项回顾性研究，使用了Optum的去标识化Clinformatics® Data Mart数据库。在这项子研究中，资格标准包括年龄≥12岁、≥1次EAD、连续符合医保资格，以及在2015年1月1日至2018年6月30日期间符合国际疾病分类第九版/第十版诊断代码中的EGPA/GPA病例定义。根据患者是否接受过免疫调节剂/环磷酰胺/甲泼尼珠单抗（ICM）或未接受过免疫调节剂/环磷酰胺/甲泼尼珠单抗（非ICM）进行分组：结果：在701名EGPA患者中，29.5%属于ICM组。总体而言，72.2%的患者有≥1处EAD重叠。ICM 组和非 ICM 组的重叠数量相似。在血液中嗜酸性粒细胞计数≥ 300 cells/µL 的患者中，22.8% 有≥ 1 个重叠的 EAD。平均每年全因费用为 98,644 美元，其中 54.1% 来自门诊病人，33.6% 来自住院病人。与 EAD 和 EGPA 相关的年平均费用分别为 23,820 美元和 9,306 美元。非 ICM 组患者的全因费用（101,560 美元对 91,684 美元）高于 ICM 组，但 EAD 相关费用（22,733 美元对 26,412 美元）和 EGPA 相关费用（6,171 美元对 16,786 美元）低于 ICM 组。全因 HCRU 和费用随着重叠度的增加而增加：EGPA与大量的HCRU和费用有关，这主要是由门诊和住院环境造成的。更多重叠的 EAD 与更高的 HCRU 和费用相关，这突出表明需要对这些患者进行治疗，以减少医疗支出。本文附有信息图表。

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Disease Overlap, Healthcare Resource Utilization, and Costs in Patients with Eosinophilic Granulomatosis with Polyangiitis: A REVEAL Sub-study.

Introduction: Eosinophilic granulomatosis with polyangiitis (EGPA) is an eosinophil-associated disease (EAD) characterized by inflammation in small- to medium-sized blood vessels. In the REal-world inVestigation of Eosinophilic-Associated disease overLap (REVEAL) study, overlap among 11 EADs was assessed. In the present sub-study, we evaluated EGPA overlap with other EADs, all-cause EAD- and EGPA-related healthcare resource utilization (HCRU) and costs, and their relationship with blood eosinophil count and treatments received.

Methods: REVEAL, a retrospective study, used Optum's de-identified Clinformatics^® Data Mart Database. In this sub-study, eligibility criteria included an age of ≥ 12 years, ≥ 1 EAD, continuous health-plan eligibility, and compliance with the EGPA/GPA case definition per International Classification of Diseases Ninth/Tenth Revision diagnostic codes between 1 January 2015 and 30 June 2018. Patients were grouped based on whether they had received immunomodulators/cyclophosphamide/mepolizumab (ICM) or not (non-ICM).

Results: Of 701 patients with EGPA, 29.5% were in the ICM group. Overall, 72.2% had ≥ 1 overlapping EAD. The number of overlaps was similar for the ICM and non-ICM groups. In patients with blood eosinophil counts ≥ 300 cells/µL, 22.8% had ≥ 1 overlapping EAD. The mean annual all-cause cost was $98,644, 54.1% of which was from outpatients and 33.6% from inpatients. The mean annual EAD- and EGPA-related costs were $23,820 and $9,306, respectively. Patients in the non-ICM group versus the ICM group had higher all-cause ($101,560 vs $91,684) but lower EAD-related ($22,733 vs $26,412) and EGPA-related ($6,171 vs $16,786) costs. All-cause HCRU and costs increased with increasing overlap.

Conclusions: EGPA was associated with substantial HCRU and costs, driven by outpatient and inpatient settings. More overlapping EADs were associated with higher HCRU and costs, highlighting the need for treatment to reduce healthcare expenditure in these patients. Infographic available for this article.

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来源期刊

Rheumatology and Therapy RHEUMATOLOGY-

CiteScore

6.00

自引率

5.30%

发文量

审稿时长

6 weeks

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