REAL-WORLD EVIDENCE ON THROMBOTIC MICROANGIOPATHIES IN GREECE: PATIENT CHARACTERISTICS AND CLINICAL OUTCOMES FROM REAL-WORLD HOSPITAL DATA OVER A 20-YEAR PERIOD
Author(s)
Antonia Sipaki, MS1, Alexandros Rekkas, PhD1, Anastasia Farmaki, MS1, Achilleas Chytas, PhDc1, Dorothea Papadopoulou, MD2, Anna Kioumi, MD2, Parthena Kyriklidou, MD2, Panagiotis Pateinakis, MD2, Eleni Manou, MD2, Gousiaris Dimitrios-Fotios, MD2, Lambros Dermentzoglou, PhD3, Dimitrios Zeimpekis, PhD2, GEORGIOS IOANNIS TORTOPIDIS, MS4, Maria Bigaki, MBA2, Nikolas Mathioudakis, PhD5, ZOE PAPAREPA, MSc5, Evangelos Chandakas, PhD6, Alexandros Sfikas, PhD5, Antonios Petropoulos, PhD5, Pantelis Natsiavas, PhD1.
1Centre for Research and Technology Hellas, CERTH, Thessaloniki, Greece, 2Papageorgiou General Hospital, Thessaloniki, Greece, 3Papageorgiou General Hospital, Thesssaloniki, Greece, 4Papageorgiou Hospital, Thessaloniki, Greece, 5AstraZeneca, Athens, Greece, 6AstraZeneca, London, United Kingdom.
1Centre for Research and Technology Hellas, CERTH, Thessaloniki, Greece, 2Papageorgiou General Hospital, Thessaloniki, Greece, 3Papageorgiou General Hospital, Thesssaloniki, Greece, 4Papageorgiou Hospital, Thessaloniki, Greece, 5AstraZeneca, Athens, Greece, 6AstraZeneca, London, United Kingdom.
OBJECTIVES: To investigate the characteristics and management of patients with Thrombotic Microangiopathies (TMAs) in a tertiary hospital.
METHODS: This retrospective, observational study was conducted using an OMOP-CDM compatible database from approximately 1.4 million patients at Papageorgiou General Hospital of Thessaloniki. The study period spanned from 1 January 2004 to 31 December 2024. The confirmed TMA cohort was defined as inpatients with a recorded diagnosis of TMA or Hemolytic Uremic Syndrome (HUS). Patient characterization was conducted by integrating laboratory results, documented therapeutic interventions and information extracted from free-text clinical notes.
RESULTS: TMA diagnosis was recorded in 74 hospital admissions, corresponding to 49 unique patients. Of these, 26 (53.1%) were female and 23 (46.9%) were male, with a median age of 44 (range 34-59). Overall, 10 (20.4%) had a confirmed diagnosis of HUS and atypical Hemolytic Uremic Syndrome (aHUS), while 39 (79.6%) represented other TMAs, including Thrombotic Thrombocytopenic Purpura (TTP) and secondary TMAs. The 5-year incidence of TMAs per 100.000 patient-years of follow-up was 0, 1.03, 0.88 and 1.72 for the periods 2004-2008, 2009-2013, 2014-2018, and 2019-2024, respectively. Testing for ADAMTS-13 antigen levels and anti-ADAMTS-13 antibodies were performed in 21 (42.8%) and 31 (63.2%) cases, respectively. The highest testing rate was observed during the 2014-2018 period (85.71%), whereas lower rates were recorded in 2004-2008, 2009-2013, and 2019-2024 (0%, 70.59%, and 58.82%, respectively). Overall, most patients (38, 77.5%) underwent plasmapheresis, while rituximab was used in 10 (20%). Among 11 cases diagnosed after 2021, patients with TTP received caplacizumab, whereas those with aHUS received ravulizumab.
CONCLUSIONS: Our findings show evidence of TMA disease management in Greece during the last 20 years providing insights on epidemiology and evolution of treatment patterns.
METHODS: This retrospective, observational study was conducted using an OMOP-CDM compatible database from approximately 1.4 million patients at Papageorgiou General Hospital of Thessaloniki. The study period spanned from 1 January 2004 to 31 December 2024. The confirmed TMA cohort was defined as inpatients with a recorded diagnosis of TMA or Hemolytic Uremic Syndrome (HUS). Patient characterization was conducted by integrating laboratory results, documented therapeutic interventions and information extracted from free-text clinical notes.
RESULTS: TMA diagnosis was recorded in 74 hospital admissions, corresponding to 49 unique patients. Of these, 26 (53.1%) were female and 23 (46.9%) were male, with a median age of 44 (range 34-59). Overall, 10 (20.4%) had a confirmed diagnosis of HUS and atypical Hemolytic Uremic Syndrome (aHUS), while 39 (79.6%) represented other TMAs, including Thrombotic Thrombocytopenic Purpura (TTP) and secondary TMAs. The 5-year incidence of TMAs per 100.000 patient-years of follow-up was 0, 1.03, 0.88 and 1.72 for the periods 2004-2008, 2009-2013, 2014-2018, and 2019-2024, respectively. Testing for ADAMTS-13 antigen levels and anti-ADAMTS-13 antibodies were performed in 21 (42.8%) and 31 (63.2%) cases, respectively. The highest testing rate was observed during the 2014-2018 period (85.71%), whereas lower rates were recorded in 2004-2008, 2009-2013, and 2019-2024 (0%, 70.59%, and 58.82%, respectively). Overall, most patients (38, 77.5%) underwent plasmapheresis, while rituximab was used in 10 (20%). Among 11 cases diagnosed after 2021, patients with TTP received caplacizumab, whereas those with aHUS received ravulizumab.
CONCLUSIONS: Our findings show evidence of TMA disease management in Greece during the last 20 years providing insights on epidemiology and evolution of treatment patterns.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
PT29
Topic
Clinical Outcomes, Epidemiology & Public Health, Real World Data & Information Systems
Disease
Rare & Orphan Diseases, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain), Urinary/Kidney Disorders