Burden of eosinophilic granulomatosis with polyangiitis by disease phase and steroid-sparing effects of biologics: a real-world retrospective study in Europe

嗜酸性肉芽肿性血管炎的疾病负担(按疾病阶段划分)及生物制剂的类固醇替代作用:一项欧洲真实世界回顾性研究

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Abstract

OBJECTIVES: The aim of the study was to describe insights into real-world characteristics and clinical outcomes of patients with a history of eosinophilic granulomatosis with polyangiitis (EGPA) across Europe, stratified by disease phase and biologics use. METHODS: This was a retrospective, physician-panel chart review study in patients with a history of EGPA from five European countries covering the period January 2015-August 2021 (GSK ID: 214661). Outcomes assessed included: baseline characteristics; treatment patterns; clinical outcomes and healthcare resource utilisation (HCRU), which were stratified post hoc by EGPA disease phase and biologics use. Oral corticosteroid (OCS) use was assessed ≤12 months pre- and post-biologics initiation. RESULTS: Overall, 407 patients were included: disease phase was identified for 381 patients (36 prodromal; 220 eosinophilic; 125 vasculitic); 185 patients received biologics, and 162 had pre-/post-biologics initiation periods identified. Patients in the vasculitic subgroup had the most comorbidities and clinical manifestations, and the greatest proportion of patients with hospitalisation versus the eosinophilic or prodromal subgroups. All subgroups had high OCS use (97.2-99.1%). The biologics-exposed subgroup had high comorbidity and HCRU burden. Post- versus pre-biologics initiation, OCS use was reduced (0.12 versus 0.69 prescriptions per person-year), the proportion of patients experiencing relapses decreased (3.1% (95% confidence interval: 0.4-5.7) versus 11.7% (6.8-16.7)) and remissions increased (26.5% (19.7-33.3) versus 13.0% (7.8-18.1). CONCLUSION: Although the vasculitic subgroup showed the greatest disease severity, all subgroups demonstrated a substantial disease burden. Results also suggest biologics provide OCS-sparing effects and improve disease control in real-world settings.

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