Comorbidities in patients with myasthenia gravis in the USA: a retrospective claims database analysis
Daniel Basoff1, Anju Parthan1, Raj Bandaru1, Anusorn Thanataveerat2, Matthew Kent3, Michael Hehir4, Ali A Habib5
1Alexion, AstraZeneca Rare Disease, Boston, MA, USA, 2Aetion, Inc., New York, NY, USA,, 3Genesis Research, 111 River St, Suite 1120, Hoboken, NJ 07030, USA, 4The University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VT, USA, 5University of California, Irvine, 1001 Health Sciences Road, Irvine, CA, USA
Objective:
To characterize the comorbidity burden in patients with MG in the USA.
Background:
Patients with myasthenia gravis (MG) often have comorbidities that contribute to their overall disease burden. These comorbidities can be at risk of exacerbation due to the conventional treatments prescribed for MG.
Design/Methods:
This US retrospective observational cohort study utilized de-identified patient data (from 01/01/2006–06/30/2019) from the IQVIA insurance claims database. Eligible patients were ≥ 18 years old; had ≥ 2 claims (≥ 30 days apart) with MG diagnoses ICD9 or ICD10 codes; and had ≥ 1 year of continuous enrollment before and after MG diagnosis. Extracted data included demographic and clinical characteristics, comorbidities, treatment history and follow-up. The prevalence of comorbidities for the overall population and by conventional MG therapies were also assessed.
Results:
Data for 3,516 patients with MG were identified (51.2% male; mean age [standard deviation], 55.8 [13.9]; age range, 18–84 years). The most prevalent comorbidities were cardiovascular and endocrine disorders, including hypertension (41.9%), hyperlipidemia (37.1%), fatigue (24.8%), uncomplicated diabetes (18.2%), cerebrovascular disease (17.6%) and hypothyroidism (15.4%). Chronic pulmonary disease (13.5%) and sleep disorders (13.2%) were also common comorbidities. Patients were often prescribed conventional MG therapies, which have the potential exacerbate their comorbid conditions. Within 1 year prior to initiation of corticosteroids, 42.7%, 18.6% and 8.6% of patients were diagnosed with hypertension, uncomplicated diabetes and osteoporosis, respectively. Similarly, 6.5% of patients prescribed chronic intravenous immunoglobulin and 14.3% of patients prescribed azathioprine were diagnosed with venous thromboembolism and malignancy, respectively, within 1 year prior to treatment initiation.
Conclusions:
This study demonstrates the high rates of comorbidities in patients with MG and the importance of considering the potential impact of these comorbidities in treatment choice discussions.