Clinical burden and healthcare resource utilization associated with myasthenia gravis: Assessments from a Japanese claims database. Issue 1 (21st January 2019)

• Record Type: Journal Article
• Authors: Murai, Hiroyuki; Hasebe, Miki; Murata, Tatsunori; Utsugisawa, Kimiaki
• Is Part Of: Clinical & experimental neuroimmunology. Volume 10:Issue 1(2019)
• Page Start: 61
• Page End: 68
• Publication Date: 2019-01-21
• Subjects: claims analysis -- complications -- health resources utilization -- myasthenia gravis -- respiratory failure; 616.80479
• DOI: 10.1111/cen3.12495
• Languages: English
• ISSNs: 1759-1961

Abstract

Abstract: Objectives: To compare the burden of illness for refractory and non‐refractory myasthenia gravis (MG) in Japanese patients. Methods: Adults in a large Japanese health insurance claims database (1 September 2008 to 31 October 2016) were included in this retrospective, observational study if they had: at least two separate claims coded as MG by a neurologist; and continuous enrollment for 12 months after any MG claim (non‐refractory cohort) or the earliest claim associated with refractory disease (refractory cohort). A cohort with Parkinson's disease was used as the reference for the burden of illness of MG, and comprised patients matched (sex, age and index date) to patients with MG. Outcomes included respiratory failure, myasthenic exacerbations, outpatient hospital and emergency room visits, and hospitalizations. Results: A significantly greater proportion of the refractory cohort ( n = 165) than the non‐refractory cohort ( n = 3137) experienced respiratory failure (17.0% vs 5.5%, respectively; P < 0.001) and/or exacerbations (57.6% vs 5.8%, respectively; P < 0.001) over 12 months. The mean numbers of hospitalizations (0.68 vs 0.09/year), emergency room visits (0.07 vs 0.03/year) and outpatient hospital visits (16.79 vs 11.88/year), and the mean duration of hospital stays (22.19 vs 2.81 days/year) were also significantly greater for the refractory cohort (all P < 0.001). Except for emergency room visits, healthcare resource utilization was significantly greater for non‐refractory MG than for Parkinson's disease ( n = 3168). Conclusions: In Japanese patients, refractory MG is associated with a greater clinical burden and healthcare resource utilization than non‐refractory MG. Abstract : An analysis of data from a Japanese health insurance claims database showed that a greater proportion of patients with refractory myasthenia gravis than non‐refractory myasthenia gravis experienced respiratory failure and/or myasthenic exacerbations over 12 months. Patients with refractory disease were more often hospitalized, more often had longer durations of hospital stays, and had more emergency room and outpatient hospital visits than patients with non‐refractory disease. The burden of illness might be significant in light of the young age of many patients with refractory myasthenia gravis.