Association between age, gender, residential region, and prevalence of subependymal giant cell astrocytoma among patients with tuberous sclerosis complex: A U.S. Healthcare Claims Database study.

Abstract

1609 Background: Subependymal giant-cell astrocytomas (SEGA) are slow growing non-cancerous tumors that can occur in patients with tuberous sclerosis complex (TSC). The objectives of this study were to examine SEGA prevalence among TSC patients in a real world setting, and to ascertain the relationships between SEGA prevalence and age groups, genders, or residential regions. Methods: We conducted a retrospective cohort study based on a large US commercial healthcare claims database. Patients with a TSC claim between 2000 and 2009 and with 12-month continuous enrollment after their first TSC claim were included into the study. SEGA was identified based on ICD-9CM codes in inpatient or outpatient claims. Patients’ genders, residential regions and ages of their first TSC claim and /or their first SEGA claim (if they had SEGA) were extracted from enrollment files respectively. SEGA prevalence was assessed with subgroup analyses of genders, age groups of first TSC claim, and residential regions. Two-sample t tests and Chi-square tests were used to explore the relationships between SEGA prevalence and age groups, genders, or residential regions. Results: The study had 2,767 patients with a mean age of 28.5 years on their first observed TSC claim, and 55.3% were female. Among these TSC patients, 7.7% had SEGA with variations by age groups of their first TSC claim (5.9% for age<1 year, 12.6% for age 1-5 years, 11.0% for age 6-10 years, 11.0% for age 11-18 years, 7.6% for age 19-25 years, and 5.1% for age 26 years or more), by genders (8.7% for males vs. 6.9% for females), and by residential regions (6.0%-11.0%). The associations between SEGA prevalence and age groups, genders or residential regions were all statistically significant with p<0.05. Conclusions: In a real world setting, and by the end of the first post-TSC year, 7.7% TSC patients had an observed SEGA diagnosis. This prevalence varied by age groups, genders, residential regions. Further research is needed to explore the factors that results into these variations.