Silver Samuel M, Houghton Katherine, Hitchens Abby, Ansquer Valérie Derrien, Ciepielewska Malgorzata
University of Michigan Medical School, Ann Arbor, Michigan, USA.
RTI Health Solutions, Manchester, UK.
J Dermatol. 2025 Mar;52(3):416-422. doi: 10.1111/1346-8138.17607. Epub 2025 Jan 6.
Erythropoietic protoporphyria (EPP) and X-linked protoporphyria (XLP) are rare genetic disorders. There are limited data regarding how these disorders are managed in real-world settings. The aim of this study was to document the characteristics and treatment patterns among patients diagnosed with EPP or XLP in general real-world settings in the United States. We, therefore, conducted a retrospective medical record review of patients diagnosed with EPP or XLP on or before July 1, 2020. Data were analyzed for patients with EPP (n = 299) and XLP (n = 91). Outcomes included demographic and clinical characteristics, diagnostic testing, therapy recommendations, office visits, emergency department visits, and hospitalizations. Costs were assigned to healthcare resources. Mean (standard deviation [SD]; median) time between the first symptom documented in the medical records and diagnosis was 2.9 (5.1; 1.3) years. The most common pre-diagnostic tests were liver function, total plasma and erythrocyte protoporphyrin, genetic tests, and renal function. Patients were advised to use sunscreen (85%) or modify their lifestyle (83%). Within 12 months of diagnosis, the mean (SD; median) number of office visits, emergency department visits, and inpatient hospitalizations related to EPP or XLP were 4.0 (3.5; 3.0), 0.8 (1.6; 0), and 0.4 (1.3; 0), respectively. Patients with EPP or XLP have several unmet needs, including timely and accurate diagnosis, symptom relief, and efficacious prevention of phototoxic reactions.
红细胞生成性原卟啉病(EPP)和X连锁原卟啉病(XLP)是罕见的遗传性疾病。关于这些疾病在现实环境中的管理方式,相关数据有限。本研究的目的是记录在美国一般现实环境中被诊断为EPP或XLP的患者的特征和治疗模式。因此,我们对在2020年7月1日或之前被诊断为EPP或XLP的患者进行了回顾性病历审查。对EPP患者(n = 299)和XLP患者(n = 91)的数据进行了分析。结果包括人口统计学和临床特征、诊断测试、治疗建议、门诊就诊、急诊科就诊和住院情况。成本被分配到医疗资源上。病历中记录的首次症状与诊断之间的平均(标准差[SD];中位数)时间为2.9(5.1;1.3)年。最常见的诊断前测试是肝功能、总血浆和红细胞原卟啉、基因测试和肾功能。建议患者使用防晒霜(85%)或改变生活方式(83%)。在诊断后的12个月内,与EPP或XLP相关的门诊就诊、急诊科就诊和住院的平均(SD;中位数)次数分别为4.0(3.5;3.0)、0.8(1.6;0)和0.4(1.3;0)。EPP或XLP患者有一些未满足的需求,包括及时准确的诊断、症状缓解以及有效预防光毒性反应。