Clinical Profile and Healthcare Resource Use of ANCA-Associated Vasculitis: A Real-World Analysis in Italy

Speaker(s)

Perrone V1, Dovizio M1, Veronesi C1, Andretta M2, Bacca M3, Barbieri A4, Bartolini F5, Cavaliere A6, Chinellato A7, Ciaccia A8, Cillo MR9, Citraro R10, Costantini A11, Dell'Orco S12, Ferrante F13, Gentile S14, Grego S15, Lavalle A14, Mancini D3, Moscogiuri R16, Mosele E17, Pagliaro R18, Procacci C19, Re D20, Santoleri F11, Ubertazzo L21, Vercellone A22, Ramirez de Arellano Serna A23, Degli Esposti L1
1CliCon S.r.l. Società Benefit Health, Economics & Outcomes Research, Bologna, BO, Italy, 2Azienda ULSS 8 Berica, Vicenza, Italy, 3ASL Brindisi, Brindisi, Italy, 4ASL Vercelli, Vercelli, Italy, 5USL Umbria 2, Terni, Italy, 6ASL Viterbo, Viterbo, Italy, 7Azienda ULSS 3 Serenissima, Mestre (VE), Italy, 8Servizio Farmaceutico Territoriale ASL Foggia, Foggia, Italy, 9ASL Salerno, Salerno, Italy, 10Azienda ospedaliero-universitaria Mater Domini, Catanzaro, Italy, 11ASL Pescara, Pescara, Italy, 12ASL Roma 6, Albano Laziale, Italy, 13ASL Frosinone, Frosinone, Italy, 14Direzione Generale per la Salute Regione Molise, Campobasso, Italy, 15ASL 3 Genovese, Genova, Italy, 16ASL Taranto, Taranto, Italy, 17UOC Assistenza Farmaceutica Territoriale Azienda ULSS 7 Pedemontana, Bassano del Grappa (VI), Italy, 18ASL Roma 5, Tivoli, Italy, 19Dipartimento Farmaceutico ASL BAT, Trani, Italy, 20ASL Teramo, Roseto degli Abruzzi, Italy, 21U.O.C. Farmacia Territoriale, ASL Roma 4, Civitavecchia (RM), Italy, 22ASL Napoli 3 SUD, Torre del Greco, Italy, 23Vifor Pharma Group, Glattbrugg, ZH, Switzerland

Presentation Documents

OBJECTIVES: ANCA-associated vasculitis (AAV) is an autoimmune diseases associated with high-rate hospitalization and poor outcomes. The analysis aimed to estimate demographic and clinical characteristics of AAV patients, their therapeutic management, outcomes, and healthcare resource use, in an Italian real-world setting.

METHODS: An observational study was conducted using Italian entities' administrative databases, covering about 12million health-assisted individuals. Adult AAV patients with i)≥1 exemption code (RG0050/RG0070) and/or hospitalization for Granulomatosis with Polyangiitis-GPA (ICD-9-CM code: 446.4) or ii) with exemption code (RG0020) for Microscopic Polyangiitis-MPA (with/without hospitalization discharge diagnosis, ICD-9-CM code:446.0) between Jan-2010-Dec-2020, were included. During one-year period before index-date (first AAV-detection), demographic and clinical characteristics (i.e. Charlson Comorbidity-Index, CCI) were evaluated. During one-year follow-up, oral glucocorticoids (GCs) prescriptions (ATC code:H02AB) and clinical outcomes (hospitalizations, end-stage renal disease-ESRD onset, and mortality) were recorded. Annual healthcare resource use/patient (all-drugs, all-outpatient specialist services-OSS, all-hospital stay) were estimated.

RESULTS: Of 859 AAV patients, 713 (83%) had GPA and 146 (17%) MPA. The estimated overall prevalence of AVV was 6.99/100,000, lower in males than in female (6.29/100,000 vs 7.65/100,00, respectively). Mean age was 57.2 years (44.6% were male), and CCI was 1.2. During follow-up, 79% (N=681) of AAV patients received GCs, 25.8% (N=222) were hospitalized (28.3% of GPA and 13.0% of MPA), 11.2% (N=96) developed ESRD (10.2% of GPA and 15.8% of MPA) and 17.8% (N=153) died (18.7% of GPA and 13.7% of MPA). The number of drugs prescribed averaged 22.1±13.8, those of hospitalizations averaged 0.7±1.2 (ordinary) and 0.3±0.6 (day-hospital), and 10.1±12.0 OSS were prescribed.

CONCLUSIONS: AAV is associated with short-term unfavorable outcomes. GPA is more frequent and resulted in a worse phenotype. The elevated healthcare resource use were mainly due to drug and OSS prescriptions and ordinary hospitalizations. Further efforts are needed to optimize AAV treatment interventions with the goal of ameliorating the clinical outcomes of AAV patients.

Code

CO61

Topic

Clinical Outcomes

Topic Subcategory

Clinical Outcomes Assessment

Disease

SDC: Rare & Orphan Diseases