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Many patients with Sjögren's syndrome in the US have additional AI diseases, receive no medication
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Many patients with Sjögren's syndrome have additional autoimmune diseases, do not receive anti-rheumatic medication and about half are diagnosed by a physician other than a rheumatologist, according to the results of a retrospective study.
Researchers used the MarketScan Commercial Claims database to identify 11,385 patients in the U.S. over 18 years with more than one inpatient or more than two outpatient visits with a Sjögren's syndrome (SS) ICD-9 code 710.2 between Jan. 1, 2006 and Dec. 31, 2011. Only patients with continuous medical and pharmaceutical benefits for 12 months or more before and after the index date of the first use of the diagnosis code were included.
Patients were 90% women with a mean age of 55 years and 39% received the initial diagnosis by a rheumatologist. Internal medicine specialists diagnosed 14.2% of the patients, family practitioners diagnosed 13.9% of patients and 6.1% were diagnosed by an ophthalmologist. About 54% had an additional autoimmune disease, including rheumatoid arthritis (17.5%), systemic lupus erythematosus (14.5%) and unspecified inflammatory polyarthropathy (6.4%).
Other comorbidities included hypertenion in 37.1% of patients, 30.9% had osteoarthritis, hyperlipidemia was present in 29.6% and mental disorders were present in 25% of the patient population.
Anti-rheumatic medications prescribed included a lowdose steroid (20 mg prednisone equivalent) for 21.3% of patients, hydroxychloroquine for 21%, topical cyclosporine for 15% and cevimeline for 14.9% of patients. About 6.1% of patients received a biologic, 37.3% received a synthetic immunomodulator and 7.1% received 20 mg prednisone equivalent.
Of the patients with comorbid autoimmune diseases, 0.3% received a biologic, 19.3% received a synthetic immunomodulator and 5.5% received 20 mg prednisone equivalent. No medications were prescribed to 15.1% of the patients studied. Health care resource utilization rose by 1.2 times higher than before diagnosis, and the total costs medical care increased to 1.4 times higher.
“Systemic disease-modifying therapies were used in a minority of SS patients and most of these patients had other autoimmune diagnoses, suggesting there may be a large unmet need in patients with SS,” the researchers concluded. – by Shirley Pulawski
Reference:
Birt J, et al. Paper #AB0526. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology. June 10-13, 2015; Rome.
Disclosure: The researchers report no relevant financial disclosures.
Please see the full study for a list of all other authors’ relevant financial disclosures.