Prevalence of Eosinophilic Granulomatosis With Polyangiitis and Associated Health Care Utilization Among Patients With Concomitant Asthma in US Commercial Claims Database

Abstract

Objective: To estimate the prevalence and associated disease burden of eosinophilic granulomatosis with polyangiitis (EGPA) in patients with asthma from a US claims database.

Methods: Two cohorts were defined using enrollees (aged ≥18 years) from the Optum deidentified Clinformatics Datamart claims database 2010-2014, based on validated EGPA case definitions with varying specificity: EGPA 1 (main cohort; more specific; patients with 2 codes [in any combination] within 12 months of each other for eosinophilia, vasculitis, or mononeuritis multiplex) and EGPA 2 (sensitivity analysis cohort; less specific; patients with 2 codes of above conditions and/or neurologic symptoms within 12 months of each other). Patients had 3 or more asthma medications in the 12-month baseline before index date (date of the second code). Eosinophilic granulomatosis with polyangiitis prevalence, asthma severity during the baseline period, oral corticosteroid (OCS) use, and health care utilization during the 12-month follow-up period were determined.

Results: Overall, 88 and 604 patients were included in main cohort EGPA 1 and sensitivity analysis cohort EGPA 2, respectively; corresponding annual EGPA prevalence rates were 3.2 to 5.9 and 23.4 to 30.7 cases/million patients. Approximately 75% of patients were prescribed OCS and ~30% experienced 1 or more hospitalization; 75% in EGPA 1 and 52% in EGPA 2 with 1 or more non-OCS prescription in the 90 days before index date had severe asthma.

Conclusions: Eosinophilic granulomatosis with polyangiitis prevalence estimates varied based on specificity of the case definition but were generally consistent with previous country-specific estimates. Despite differences in prevalence, both cohorts displayed a generally similar, high burden of OCS use and health care utilization, highlighting the substantial disease burden among patients with EGPA and the need for specific treatments.

FIGURE 1

Eosinophilic granulomatosis with polyangiitis prevalence (Optum CDM database, 2010–2014). *EGPA 1 (main cohort) based on at least 2 diagnosis codes (in any combination) for either eosinophilia and vasculitis, or vasculitis and mononeuritis multiplex; PPV ≥80%; ^†EGPA 2 (sensitivity analysis cohort) based on at least 2 diagnosis codes (in any combination) for either eosinophilia and vasculitis, vasculitis and mononeuritis multiplex, or vasculitis and neurologic symptoms; PPV ≥40%.

FIGURE 2

Health care utilization among patients with EGPA during the 1-year follow-up period (Optum CDM database, 2010–2014). *EGPA 1 (main cohort) based on at least 2 diagnosis codes (in any combination) for either eosinophilia and vasculitis, or vasculitis and mononeuritis multiplex; PPV ≥80%; ^†EGPA 2 (sensitivity analysis cohort) based on at least 2 diagnosis codes (in any combination) for either eosinophilia and vasculitis, vasculitis and mononeuritis multiplex, or vasculitis and neurologic symptoms; PPV ≥40%.