A Targeted Literature Review of Economic Evaluations, Health-Related Quality of Life, Healthcare Resource Use, and Economic Outcomes Associated With Giant Cell Arteritis

OBJECTIVES: Giant cell arteritis (GCA) is a systemic inflammatory disorder that leads to narrowing of medium and large-sized vessels, leading to ischemia causing a range of symptoms. Glucocorticoids (GC) are the standard of care; however new GC-sparing treatments are needed to enable sustained remission with improved safety. The aim of this study was to identify, and summarize existing literature on economic evaluations, health-related quality of life (HRQoL), healthcare resource utilization (HCRU) and costs in adult patients with GCA, and subsequently identify relevant knowledge gaps.

METHODS: A targeted literature review was conducted in July 2023. Search strategies were implemented in MEDLINE (Ovid), EMBASE, CENTRAL, CDSR, HTA and NHS economic evaluation databases. Hand searches on HTA websites and key congresses were also performed. Study selection, data extraction and summary of findings were conducted using current best practices.

RESULTS: Out of 1,029 studies identified; 46 met the inclusion criteria. Six economic evaluations were identified with a majority of studies using a semi-Markov model and payer perspective. HRQoL/utility studies (n= 17) demonstrated significantly impaired HRQoL in individuals with GCA versus non-GCA (physical functioning, physical role, and emotional role in the SF-36). Importantly, patients with active disease reported worse HRQoL versus patients in remission. Review of HCRU and cost studies (n= 23) showed that individuals with GCA had significantly increased HCRU versus general/reference population, especially in terms of hospitalization and physician/ER visits. Direct costs mostly focused on hospitalizations, AE-related, prescription & outpatient costs and were higher for GCA patients with polymyalgia rheumatica compared to patients with GCA only. No data was identified on work productivity, indirect costs and/or impact on caregivers.

CONCLUSIONS: GCA is associated with significantly impaired HRQoL, increased HCRU and associated costs. A number of evidence gaps were identified, and further research is needed to fully understand the GCA disease burden.