Comorbidities in patients with myasthenia gravis in the USA: a retrospective claims database analysis (P1-5.003)

Abstract

<h3>Objective:</h3> To characterize the comorbidity burden in patients with MG in the USA. <h3>Background:</h3> 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. <h3>Design/Methods:</h3> 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. <h3>Results:</h3> 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. <h3>Conclusions:</h3> 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. <b>Disclosure:</b> Dr. Basoff has received personal compensation for serving as an employee of Alexion Pharmaceuticals. Anju Parthan has received personal compensation for serving as an employee of Alexion. Anju Parthan has received personal compensation for serving as an employee of Alkermes. Anju Parthan has received stock or an ownership interest from Alexion. Mr. Bandaru has received personal compensation for serving as an employee of Alexion Pharmaceuticals. Dr. Thanataveerat has received personal compensation for serving as an employee of Genesis Research. Dr. Thanataveerat has received personal compensation for serving as an employee of Aetion. Mr. Kent has nothing to disclose. Dr. Hehir has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Argenx. Dr. Hehir has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alexion. Dr. Hehir has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB Pharma. Dr. Hehir has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Habib has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion. Dr. Habib has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for argenx. Dr. Habib has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Immunovant. Dr. Habib has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. Dr. Habib has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pfizer. Dr. Habib has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Habib has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH/NINDS. Dr. Habib has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Alexion. Dr. Habib has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for argenx. The institution of Dr. Habib has received research support from Alexion. The institution of Dr. Habib has received research support from RA pharmaceuticals. The institution of Dr. Habib has received research support from Immunovant. The institution of Dr. Habib has received research support from UCB. The institution of Dr. Habib has received research support from argenx. The institution of Dr. Habib has received research support from CabalettaBio. The institution of Dr. Habib has received research support from Genentech. The institution of Dr. Habib has received research support from Regeneron.