Eosinophilic granulomatosis with polyangiitis: Patient profiles from a large US allergy practice

Michael E. Wechsler MD , Anna Kovalszki MD , Jared Silver MD, PhD , Brian Stone MD , William McCann MD , Lynn Huynh MPH, DrPH , Anamika Khanal BA , Mingchen Ye MS , Mei Sheng Duh MPH, ScD , Arijita Deb PhD
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Abstract

Background

Data on the presentation and management of patients with eosinophilic granulomatosis with polyangiitis (EGPA) in private practice are limited.

Objective

We sought to characterize the profiles and disease burden of patients with EGPA in a real-world private practice setting.

Methods

This was a retrospective, noninterventional, longitudinal study (GSK ID: 217426) of US Allergy Partners network data. For patients with a diagnosis of EGPA, confirmed by 2 or more EGPA clinical features, index was defined as their first visit with an Allergy Partners physician (January 2007–June 2021); postindex lasted until loss of follow-up or study end (December 2021). Patient characteristics at index, physician characteristics at any time, symptoms, treatment characteristics, and clinical outcomes postindex were assessed.

Results

Of 52 patients (median follow-up, 3.7 years), 75% were diagnosed with EGPA outside the Allergy Partners network. Each patient received care from a median (Q1-Q3) of 4.0 (3.0-5.0) physician specialties. Most had asthma (92%), rhinitis (75%), and sinusitis (62%) and experienced a mean ± SD of 18.1 ± 4.3 distinct self-reported symptoms. Most (85%) used oral corticosteroids, with 73% (32 of 44) on daily doses of more than 12 mg; 60% used mepolizumab. Overall, 75% of patients (39 of 52) achieved a response (improved/controlled symptoms); 46% (24 of 52) achieved controlled status after worsened, unchanged, or active symptoms, and of these 38% (9 of 24) relapsed.

Conclusions

The complex private practice presentation of EGPA, with heterogeneous patient response to standard treatments, highlights a significant disease burden and continued need for optimized treatment strategies within a multidisciplinary team approach.
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嗜酸性肉芽肿病合并多血管炎:来自美国大型过敏实践的患者概况
背景:私人诊所中嗜酸性肉芽肿病合并多血管炎(EGPA)患者的表现和治疗数据有限。目的:我们试图在现实世界的私人执业环境中描述EGPA患者的概况和疾病负担。方法:对美国过敏伙伴网络数据进行回顾性、非介入性、纵向研究(GSK ID: 217426)。对于诊断为EGPA的患者,经2项或更多EGPA临床特征证实,指数定义为他们首次就诊过敏伙伴医生(2007年1月至2021年6月);postindex持续到失去随访或研究结束(2021年12月)。评估指数时的患者特征、任何时间的医生特征、症状、治疗特征和指数后的临床结果。结果在52例患者中(中位随访3.7年),75%的患者在过敏伙伴网络之外被诊断为EGPA。每位患者接受的护理中位数(Q1-Q3)为4.0(3.0-5.0)个医师专科。大多数患者患有哮喘(92%)、鼻炎(75%)和鼻窦炎(62%),平均±SD为18.1±4.3种不同的自我报告症状。大多数(85%)使用口服皮质类固醇,73%(44人中有32人)每日剂量超过12毫克;60%的患者使用了mepolizumab。总体而言,75%的患者(52例中的39例)获得了缓解(症状改善/控制);46%(52人中的24人)在症状恶化、未改变或活跃后达到控制状态,其中38%(24人中的9人)复发。结论:EGPA在私人诊所的复杂表现,以及患者对标准治疗的不同反应,突出了显著的疾病负担,并继续需要在多学科团队方法中优化治疗策略。
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来源期刊
The journal of allergy and clinical immunology. Global
The journal of allergy and clinical immunology. Global Immunology, Allergology and Rheumatology
CiteScore
0.70
自引率
0.00%
发文量
0
审稿时长
92 days
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