Xu Xiao, Edmonds Christopher, Kim YongJin, Stokes Michael, Stirnadel-Farrant Heide A, Kwiatek Justin, Katial Rohit
BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, USA.
Global Price and Market Access, AstraZeneca, Gaithersburg, MD, USA.
Rheumatol Ther. 2024 Dec;11(6):1611-1628. doi: 10.1007/s40744-024-00714-w. Epub 2024 Oct 24.
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.
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).
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.
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.
嗜酸性肉芽肿性多血管炎（EGPA）是一种嗜酸性粒细胞相关疾病（EAD），其特征为中小血管炎症。在嗜酸性粒细胞相关疾病重叠的真实世界调查（REVEAL）研究中，评估了11种EAD之间的重叠情况。在本亚研究中，我们评估了EGPA与其他EAD的重叠情况、全因EAD及EGPA相关的医疗资源利用（HCRU）和成本，以及它们与血液嗜酸性粒细胞计数和接受治疗的关系。
REVEAL是一项回顾性研究，使用了Optum的去识别化临床信息数据集市数据库。在本亚研究中，纳入标准包括年龄≥12岁、≥1种EAD、持续的健康计划资格，以及符合2015年1月1日至2018年6月30日期间国际疾病分类第九版/第十版诊断代码的EGPA/GPA病例定义。患者根据是否接受过免疫调节剂/环磷酰胺/美泊利珠单抗（ICM）分为两组（未接受ICM组）。
在701例EGPA患者中，29.5%属于ICM组。总体而言，72.2%的患者有≥1种重叠的EAD。ICM组和非ICM组的重叠数量相似。在血液嗜酸性粒细胞计数≥300个/μL的患者中，22.8%有≥1种重叠的EAD。年全因平均成本为98,644美元，其中54.1%来自门诊，33.6%来自住院。年EAD及EGPA相关成本分别为23,820美元和9,306美元。非ICM组患者与ICM组相比，全因成本更高（101,560美元对91,684美元），但EAD相关成本（22,733美元对26,412美元）和EGPA相关成本（6,171美元对16,786美元）更低。全因HCRU和成本随着重叠数量的增加而增加。
EGPA与大量的HCRU和成本相关，主要由门诊和住院环境驱动。更多重叠的EAD与更高 的HCRU和成本相关，这突出了需要进行治疗以降低这些患者的医疗支出。本文提供信息图表。
