Characteristics and Healthcare Utilization of Patients with Myasthenia Gravis Who Developed Exacerbation
Author(s)
Lin Y1, Qi Z2, Li Y3, Vu T4, De Ruyck F5, Shi L6
1Tulane University, NEW ORLEANS, LA, USA, 2Argenx US Inc., Boston, MA, USA, 3Cleveland Clinic, Cleveland, OH, USA, 4University of South Florida, Tampa, FL, USA, 5Argenx BVBA, Ghent, Belgium, 6Tulane University, New Orleans, LA, USA
Presentation Documents
OBJECTIVES:
Our study aimed to describe the characteristics of patients with myasthenia gravis (MG) who developed exacerbation (MG-E) and compare their healthcare utilization (HRU) to those with MG who did not experience exacerbation (MG-O).METHODS:
We extracted de-identified data from the National Veterans Affairs (VA) electronic health records between 1999 and 2022 on patients who had 2 or more MG-related diagnostic code submissions. The index date was defined as the first recorded MG diagnosis. Descriptive statistics were used to compare the baseline characteristics between patients with MG-E and MG-O. Kaplan-Meier analysis was applied to estimate the risk of exacerbation among the patients with MG. The per-patient per-year (PPPY) HRU was compared between the 2 groups.RESULTS:
33.6% (3,603/10,718) of patients with MG developed exacerbation over a median follow-up of 6.8 years. Approximately 32% of the 3603 patients had >5 recurrent exacerbation events, with 1.38 (S.D. 2.50) exacerbations per year. Among patients with MG-E, Hispanic and Black patients and patients residing in the West had higher cumulative incidence over time (p-value <0.0001). More patients with MG-E had early-onset MG (age at initial MG diagnosis<50 yrs), and they had higher Charlson Comorbidity Index and more medical conditions (e.g., autoimmune-associated conditions, thymoma, etc.) before their first MG diagnosis. Not surprisingly, patients with MG-E had greater HRU PPPY than patients with MG-O after the initial MG diagnosis (outpatient visit: 25.05 vs 14.08; inpatient stay 0.47 vs 0.14; ED visit: 0.69 vs 0.26; ICU stay: 0.08 vs 0.02, respectively; p-value <0.001). Additionally, they had a higher incidence of intubation (p-value <0.0001).CONCLUSIONS:
Approximately one-third of MG patients experienced exacerbations, with higher incidences seen among Hispanic and Black patients. MG exacerbation is associated with higher HRU and intubation risks, and inflicts a substantial burden of disease on MG patients.Conference/Value in Health Info
2023-05, ISPOR 2023, Boston, MA, USA
Value in Health, Volume 26, Issue 6, S2 (June 2023)
Code
CO218
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment
Disease
Rare & Orphan Diseases