RATIONALE: Unlike severe uncontrolled asthma (SUA), eosinophilic granulomatosis with polyangiitis (EGPA) affects several organs. Real-world data are sparse in patients with EGPA. This retrospective analysis of US administrative health insurance claims data (MarketScan® or Medicare) quantified the impact of EGPA on comorbidity burden.
METHODS: Patients with newly diagnosed EGPA during 2017–2021 with ≥12 months of continuous pre-diagnostic health plan enrolment and ≥1 day of post-diagnostic follow-up were included, and matched with ≤4 people with SUA, based on demographic and enrollment characteristics. Comorbidities and symptoms at EGPA diagnosis or matched inclusion date were assessed.
RESULTS: 281/213 patients with EGPA were matched to 640 with SUA. At diagnosis, patients with EGPA versus SUA had a higher proportion of certain comorbidities (e.g. arrythmias [19.8% vs 10.5%; p<0.001], ischemic heart disease [18.7% vs 12.0%; p=0.019]), and more existing major EGPA-related symptoms (e.g. respiratory failure [19.2% vs 2.8%; p<0.001], hematuria [8.2% vs 2.5%; p<0.001], cerebrovascular accident [5.5% vs 1.1%; p<0.001], cardiomyopathy [5.5% vs 1.3%; p=0.002]). After diagnosis, fewer patients with EGPA versus SUA had new symptoms of respiratory failure (2.7% vs 6.9%; p=0.048). At the end of follow-up, more patients with EGPA versus SUA had experienced ear/nose/throat (ENT; 55.5% vs 24.7%; p<0.001), ocular (22.5% vs 14.4%; p=0.007), and renal (6.0% vs 1.9%; p=0.004) dysfunction, but fewer had had respiratory dysfunction (86.8% vs 97.8%; p<0.001).
CONCLUSIONS: Comorbidity and symptom burdens differed between patients with EGPA versus SUA alone. The comorbidity burden in SUA was respiratory-related, and in EGPA it was ENT-, ocular- and renal-related.
