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欧洲嗜酸性肉芽肿性多血管炎的疾病负担。

Burden of eosinophilic granulomatosis with polyangiitis in Europe.

作者信息

Jakes Rupert W, Kwon Namhee, Huynh Lynn, Hwee Jeremiah, Baylis Lee, Alfonso-Cristancho Rafael, Du Shawn, Khanal Anamika, Duh Mei Sheng, Terrier Benjamin

机构信息

Epidemiology, GSK, London, UK.

Clinical Sciences, Respiratory, GSK, London, UK.

出版信息

ERJ Open Res. 2024 Aug 5;10(4). doi: 10.1183/23120541.00912-2023. eCollection 2024 Jul.

Abstract

BACKGROUND AND AIMS

Real-world evidence characterising the burden of eosinophilic granulomatosis with polyangiitis (EGPA) in Europe is limited. The aim of this study was to characterise patients in a large European EGPA cohort.

METHODS

This retrospective, non-interventional, longitudinal study (GSK ID: 214661) recruited cross-specialty physicians from France, Germany, Italy, Spain and the UK to conduct medical chart reviews for patients with a physician-confirmed diagnosis of EGPA. Patients were ≥12 years of age at diagnosis with ≥1 year of follow-up data from the first clinical visit with the physician (index date). Outcome measures collected from index date to end of follow-up included clinical manifestations and healthcare resource utilisation (HCRU).

RESULTS

In total, 407 patient medical charts were reviewed by 204 physicians; median (interquartile range) duration of follow-up from index date was 2.2 (1.7-3.5) years. Most patients (73.5%) had asthma. Patients underwent multiple diagnostic assessments, and 74.9% received ≥3 different therapies between diagnosis and end of follow-up (98.8% oral corticosteroids, 63.9% immunosuppressive therapies, 45.5% biologics). During follow-up, 84.5% of patients experienced EGPA clinical manifestations; most were considered moderate or severe and commonly affected the lungs (55.8%; including lung infiltrates 25.8% and severe asthma 24.8%), ear, nose and throat (53.3%), and skin (41.8%). HCRU was substantial: 26.0% of patients made emergency department visits, 36.6% were hospitalised and 84.8% had outpatient visits.

CONCLUSIONS

These real-world data show that EGPA presents a substantial burden to patients and the healthcare system. Earlier and better differential diagnosis and appropriate treatment may help reduce incidence of clinical manifestations and HCRU.

摘要

背景与目的

关于欧洲嗜酸性肉芽肿性多血管炎(EGPA)负担的真实世界证据有限。本研究旨在描述一个大型欧洲EGPA队列中的患者特征。

方法

这项回顾性、非干预性纵向研究(GSK编号:214661)招募了来自法国、德国、意大利、西班牙和英国的跨专业医生,对经医生确诊为EGPA的患者进行病历审查。患者诊断时年龄≥12岁,且有自首次就诊医生(索引日期)起≥1年的随访数据。从索引日期到随访结束收集的结局指标包括临床表现和医疗资源利用(HCRU)。

结果

共有204名医生审查了407份患者病历;从索引日期起的中位(四分位间距)随访时间为2.2(1.7 - 3.5)年。大多数患者(73.5%)患有哮喘。患者接受了多项诊断评估,74.9%的患者在诊断至随访结束期间接受了≥3种不同治疗(98.8%口服糖皮质激素,63.9%免疫抑制治疗,45.5%生物制剂)。随访期间,84.5%的患者出现EGPA临床表现;大多数被认为是中度或重度,常见受累部位为肺部(55.8%;包括肺部浸润25.8%和重度哮喘24.8%)、耳鼻喉(53.3%)和皮肤(41.8%)。医疗资源利用情况严重:26.0%的患者前往急诊科就诊,36.6%的患者住院,84.8%的患者有门诊就诊。

结论

这些真实世界数据表明,EGPA给患者和医疗系统带来了沉重负担。更早、更准确的鉴别诊断和适当治疗可能有助于降低临床表现的发生率和医疗资源利用情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27e3/11299011/f45c09ee48d0/00912-2023.01.jpg

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