RELAPSE AND ASSOCIATED HEALTHCARE BURDEN IN POLYMYALGIA RHEUMATICA (PMR) AND GIANT CELL ARTERITIS (GCA): A RETROSPECTIVE COHORT STUDY IN GERMANY
Author(s)
Bernhard Hellmich, MD1, Pooja Shah, PhD2, Parnian Eghbalian, PhD3, Fraence Hardtstock, PhD3, Anja CENGIA, PhD4, Marco Alibone, PhD5, Benjamin Haeberle, PhD6, Valeria Jordan Mondragon, MD7, RAMAKRISHNA GEDDAM SRI, PhD8, Julie Le Moal Mouchet, PhD9.
1Medius Klinik, Kirchheim, Germany, 2CYTEL, TORONTO, ON, Canada, 3CYTEL, BERLIN, Germany, 4Ingef, BERLIN, Germany, 5InGef - Institut für angewandte Gesundheitsforschung, BERLIN, Germany, 6NOVARTIS, BERLIN, Germany, 7Novartis A.G., BASEL, Switzerland, 8Novartis Healthcare Private Limited, Hyderabad, India, 9Novartis A.G., Basel, Switzerland.
1Medius Klinik, Kirchheim, Germany, 2CYTEL, TORONTO, ON, Canada, 3CYTEL, BERLIN, Germany, 4Ingef, BERLIN, Germany, 5InGef - Institut für angewandte Gesundheitsforschung, BERLIN, Germany, 6NOVARTIS, BERLIN, Germany, 7Novartis A.G., BASEL, Switzerland, 8Novartis Healthcare Private Limited, Hyderabad, India, 9Novartis A.G., Basel, Switzerland.
OBJECTIVES: To assess relapse frequency, healthcare resource utilization (HCRU), and associated costs among patients with polymyalgia rheumatica (PMR) and/or giant cell arteritis (GCA) in Germany.
METHODS: This retrospective cohort study used a German claims database (InGef). Adults aged ≥50 years newly diagnosed with either PMR, GCA, or PMR+GCA between 2017 and 2023 were identified. Patients required ≥12 months of continuous insurance pre- and post-index and ≥2 oral glucocorticoid (GC) prescriptions within 6 months follow-up (FU) period. Cohorts included GCA (ICD-10-GM: M31.6), PMR (M35.3), and concomitant PMR+GCA (M31.5). Relapses were defined by claims-based evidence of GC intensification (intravenous GC use or oral GC dose escalation, excluding other GC-indicated conditions) and/or hospitalization for GCA/PMR (main diagnosis) or related symptoms accompanied by subsequent GC intensification. Active disease was defined as the 30 days following relapse or duration of GCA/PMR hospitalization, with all remaining FU classified as stable disease. Outcomes included annualized relapse rate (ARR), healthcare resource use, and costs, reported per person-year (PPY).
RESULTS: A total of 970 patients with GCA, 12,634 with PMR, and 1,595 with concomitant PMR+GCA were identified. Most patients were women aged ≥70 years. Mean FU ranged from 47.2-52.9 months across cohorts. Most common comorbidities included hypertension (64.6-68.5%) and cardiovascular disease (49.2-57.5%). ARR was 0.17, 0.27, and 0.29 PPY for GCA, PMR, and PMR+GCA cohorts, with 32.2%, 50.2%, and 51.2% experiencing at least 1 relapse during FU, respectively. Active disease periods were associated with 2.5-2.7-fold higher rheumatologist visits, 1.3-2.0-fold higher all-cause hospitalizations, 2.0-2.6-fold higher sick days, and generally higher healthcare costs versus stable disease, across all three cohorts.
CONCLUSIONS: In this real-world German cohort, relapses were frequent in PMR and/or GCA under current standards of care and were associated with substantially increased HCRU and healthcare costs during active disease periods.
METHODS: This retrospective cohort study used a German claims database (InGef). Adults aged ≥50 years newly diagnosed with either PMR, GCA, or PMR+GCA between 2017 and 2023 were identified. Patients required ≥12 months of continuous insurance pre- and post-index and ≥2 oral glucocorticoid (GC) prescriptions within 6 months follow-up (FU) period. Cohorts included GCA (ICD-10-GM: M31.6), PMR (M35.3), and concomitant PMR+GCA (M31.5). Relapses were defined by claims-based evidence of GC intensification (intravenous GC use or oral GC dose escalation, excluding other GC-indicated conditions) and/or hospitalization for GCA/PMR (main diagnosis) or related symptoms accompanied by subsequent GC intensification. Active disease was defined as the 30 days following relapse or duration of GCA/PMR hospitalization, with all remaining FU classified as stable disease. Outcomes included annualized relapse rate (ARR), healthcare resource use, and costs, reported per person-year (PPY).
RESULTS: A total of 970 patients with GCA, 12,634 with PMR, and 1,595 with concomitant PMR+GCA were identified. Most patients were women aged ≥70 years. Mean FU ranged from 47.2-52.9 months across cohorts. Most common comorbidities included hypertension (64.6-68.5%) and cardiovascular disease (49.2-57.5%). ARR was 0.17, 0.27, and 0.29 PPY for GCA, PMR, and PMR+GCA cohorts, with 32.2%, 50.2%, and 51.2% experiencing at least 1 relapse during FU, respectively. Active disease periods were associated with 2.5-2.7-fold higher rheumatologist visits, 1.3-2.0-fold higher all-cause hospitalizations, 2.0-2.6-fold higher sick days, and generally higher healthcare costs versus stable disease, across all three cohorts.
CONCLUSIONS: In this real-world German cohort, relapses were frequent in PMR and/or GCA under current standards of care and were associated with substantially increased HCRU and healthcare costs during active disease periods.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE586
Topic
Clinical Outcomes, Economic Evaluation, Real World Data & Information Systems
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)