Penn State College of Medicine, Hershey, Pennsylvania.
Penn State College of Medicine, Hershey, Pennsylvania and The Ehlers-Danlos Society, London, UK.
Arthritis Care Res (Hoboken). 2023 May;75(5):1183-1188. doi: 10.1002/acr.24819. Epub 2022 Nov 20.
Joint hypermobility in Ehlers-Danlos Syndromes (EDS) predisposes persons with EDS to frequent subluxations and dislocations, chronic arthralgia, and soft-tissue rheumatism. Epidemiologic trends of rheumatologic conditions among persons with EDS are lacking. Prescription claims databases can reflect underlying disease burdens by using medication claims as disease proxies. We examined the prevalence of prescription claims for commonly prescribed immunomodulator and antiinflammatory (IMD) drugs among persons with EDS compared with their matched control person, and hypothesized peripubertal increases among female persons with EDS.
We compared the percentages of IMD drug prescription claims among 3,484 persons with EDS (ages 5-62 years) against their age-, sex-, state of residence-, and earliest claim date-matched control persons using 10 years (2005-2014) of private prescription claims data and a minimum 2-year enrollment inclusion criterion.
Our cohort comprised 70% adults and 74% female persons. At least 1 IMD medication was prescribed to 65.4% of persons with EDS compared with 47.4% of control persons. We observed 1.3 to 4.2 times higher odds (P < 0.0001) for 5 out of 6 IMD drug classes among persons with EDS compared with matched control persons, except for biologic agents (conditional odds ratio 1.3, 95% confidence interval 0.8-2.0). Peripubertal increases were observed for nonsteroidal antiinflammatory drugs, oral, and injectable steroids.
To our knowledge, our study is the first to examine the full range of IMD drug prescription claim trends among persons with EDS. We believe our research findings can have notable diagnostic and management implications for EDS patients who present with multiple comorbidities and generally require a more granular assessment of their medical conditions.
埃勒斯-当洛斯综合征（EDS）中的关节过度活动使患者容易频繁出现半脱位和脱位、慢性关节痛和软组织风湿病。EDS 患者的风湿性疾病的流行病学趋势尚不清楚。处方索赔数据库可以通过使用药物索赔作为疾病替代物来反映潜在的疾病负担。我们检查了与匹配对照相比，EDS 患者常见的免疫调节剂和抗炎（IMD）药物的处方索赔的患病率，并假设青春期后女性 EDS 患者的发病率增加。
我们比较了 3484 名 EDS 患者（年龄 5-62 岁）与年龄、性别、居住州和最早索赔日期相匹配的对照患者的 IMD 药物处方索赔百分比，使用了 10 年（2005-2014 年）的私人处方数据和至少 2 年的入组纳入标准。
我们的队列包括 70%的成年人和 74%的女性患者。与对照患者相比，至少有 1 种 IMD 药物被开具给 65.4%的 EDS 患者。与匹配对照患者相比，我们观察到 5 种 IMD 药物中有 1.3 到 4.2 倍（P<0.0001）的更高的可能性，除了生物制剂（条件比值比 1.3，95%置信区间 0.8-2.0）外。青春期后非甾体抗炎药、口服和注射类固醇的使用有所增加。
据我们所知，我们的研究是首次检查 EDS 患者 IMD 药物处方索赔趋势的全部范围。我们认为，我们的研究结果可能对患有多种合并症的 EDS 患者具有显著的诊断和管理意义，这些患者通常需要更详细地评估他们的病情。
