OBJECTIVES

Symptomatic uterine fibroids (UF), the most common benign pelvic tumors in US women, have a substantial impact on women’s wellness. The most common symptom of UF leading to treatment is HMB. However, pain, anemia and fatigue may necessitate medical intervention. The main objective was to describe clinical characteristics and treatment (hysterectomy and hormonal therapy) of women with medical claims for UF but not HMB.

METHODS

A retrospective analysis of IQVIA PharMetrics US claims database (1/1/2010-12/31/2019), identified women 18-50 years with incident UF, no UF diagnosis during pre-index and no HMB claims. Index date was defined as date of first claim for UF. Continuous enrollment 12-months pre- and > 24 months post-index was required. Prior and post-diagnosis treatment (prescriptions and surgeries) were identified; logistic regression models were used to determine factors associated with specific treatments.

RESULTS

92,381 women had a UF claim, of which 26,068 (28.2%) had no HMB claim. Among these, mean age was 41.8 years (SD: 6.3). Patients had claims associated with the following diagnoses: pain (9,535, 36.6%), fatigue (4,038, 15.5 %), abnormal bleeding (2,993, 11.5%), infertility (1,606, 6.2%) and anemia (1,330, 5.1%). Within a year of UF diagnosis, higher age, pain, prior hormonal treatment, and prior narcotic use were associated with a higher likelihood for a hysterectomy, whereas infertility, abnormal bleeding, post-diagnosis hormonal treatment and analgesic use (Ps < 0.05) were associated with lower likelihood. Abnormal bleeding, infertility, hysterectomy, and other surgical procedures were associated with a higher likelihood for hormonal treatment within a year of UF diagnosis, whereas age (Ps < 0.05) was associated with lower likelihood.

CONCLUSIONS:

In symptomatic women diagnosed with UF without a HMB diagnosis claim, pain was the most common symptom and associated with hysterectomy treatment. UF-associated HMB in claims may be less frequent than what is found in clinical practice.