Real-World Analysis of Patient Characteristics, Adverse Events, and Economic Burden Among Patients with Giant Cell Arteritis Treated with Glucocorticoids
摘要
Giant cell arteritis (GCA) typically requires long-term treatment with glucocorticoids (GC). However, prolonged use of GCs has been associated with increased risk of GC-related side effects and adverse events. This study assessed the burden of GCs in GCA across the comprehensive framework of 39 adverse events, across 11 clinical categories, and side effects commonly associated with GC use (GRAEs).
MethodsThis retrospective, observational study leveraged Merative MarketScan® databases (01/01/2009–12/31/2020), identified patient newly diagnosed with GCA, and assessed GC use, GRAE events, healthcare resource utilization (HCRU), and costs for ≥ 12 months up to 60 months post GC initiation. Eligible patients were ≥ 50 years old, with continuous plan enrollment for ≥ 12 months post-index GCA diagnosis (GCA + GC cohort) and were newly treated with GCs. Patients in the GCA + GC cohort were compared with a control cohort with no GCA and no GC (CC1) and a second control cohort of no GCA (CC2).
ResultsPatients with GCA + GC versus control cohorts had significantly (p < 0.001) higher occurrence of 38 of 39 GRAEs assessed, with absolute differences ranging from 3% among musculoskeletal events to 20% among bone-related events. Patients in the GCA + GC cohort had greater HCRU compared with both control cohorts; compared to CC1, patients with GCA + GC had two times higher rates of hospitalization, and greater mean all-cause medical costs ($37,936 ± $65,325 vs $12,498 ± $48,793; p < 0.001) and results were similar when compared to CC2. Accounting for GRAEs, GCA-related costs more than doubled ($6337 ± $14,460 vs $13,995 ± $30,987).
ConclusionPatients newly diagnosed with GCA and newly treated with GCs experience significantly higher rates of GRAEs in every category and two-fold higher healthcare costs. These data reflect the medical and financial burden for patients with GCA receiving GCs and establishes a comprehensive framework for assessing GC-related conditions for inflammatory diagnoses.