Dolin P, Kielar D, Shavit A, Keogh KA, Rowell J, Edmonds C, Meyers J, Esterberg L, Nham T, Chen SY. Diagnosis pathways in patients with eosinophilic granulomatosis with polyangiitis (EGPA): a retrospective analysis of US health insurance claims data. Poster presented at the 2023 Eastern Pulmonary Conference; September 21, 2023. West Palm Beach, FL.

INTRODUCTION: Raising awareness of EGPA, a rare necrotizing small-to-medium vessel vasculitis, is important for timely diagnosis/treatment. We characterized the diagnostic journey of patients with EGPA using a retrospective analysis of US health insurance claims (Merative™ MarketScan® databases).

METHODS: Patients with newly diagnosed EGPA (2017-2021) with ≥12 months continuous pre-diagnosis health plan enrollment and ≥1 inpatient or ≥2 outpatient EGPA-related diagnoses (≥90 days apart, ICD-10-CM code M30.1) were included. Follow-up was from date of first observed EGPA diagnosis (index date; ID) until health plan disenrollment/database end.

RESULTS: 236 patients with incident EGPA were identified. At ID, mean (standard deviation [SD]) age was 50.4 (14.5) years, 88% were <65 years, and 58% were female. In the year before ID, 80% of patients were receiving systemic glucocorticoids (oral glucocorticoids [OGCs], 77%); 13.6% immunosuppressants; 12.7% biologics; and 96% had ≥1 outpatient visit (family practice, 50%; internal medicine, 45%). The most frequent (mean [SD]) outpatient visits were to allergy/immunology (6.2 [8.0]), family practice (4.7 [4.2]), and internal medicine (4.3 [3.6]). 31% and 70% of patients had their first observed EGPA diagnosis in an inpatient and/or outpatient setting, respectively; mostly acute care hospital specialists, followed by internal medicine, and pulmonary disease specialists. The mean (SD) time from first observed EGPA symptom/organ damage to first observed EGPA diagnosis was 25.0 (15.0) months; >99% of patients experienced symptoms/organ damage prior to diagnosis. At ID, 95% of patients had persistent damage to ≥1 organ; mostly pulmonary damage, followed by ear, nose, and throat, and cardiovascular damage.

CONCLUSIONS: Prior to diagnosis, most patients with EGPA were prescribed OGCs and made frequent health care provider (HCP) visits. At diagnosis, most patients had already experienced an EGPA event/organ damage for >2 years. These data highlight the need for greater EGPA awareness amongst HCPs to facilitate more rapid diagnosis and minimize organ damage.