Disease burden, healthcare resource utilisation, and treatment patterns in patients with newly diagnosed myasthenia gravis in England: a retrospective cohort study
Abstract
Background: Myasthenia gravis (MG), a chronic and unpredictable autoimmune disease, is associated with multiple comorbidities and high disease burden.
Objective: To assess the disease burden, healthcare resource utilisation (HCRU), and treatment patterns of patients with newly diagnosed MG in England.
Methods: Data from Clinical Practice Research Datalink GP practices linked to the Hospital Episode Statistics database were used. Eligible patients had ≥1 diagnostic code for MG, with the first MG diagnostic code recorded between 01 January 2010 and 31 December 2019. Non-MG controls were selected if they had no recorded MG diagnosis and ≥12 months of data. Controls were matched for age, sex and GP practice in a maximum ratio of 5:1.
Results: Mean follow-up duration was 2.8 and 3.1 years for the MG and non-MG cohorts, respectively. In the MG cohort, 56% of patients were male, with a mean age of 67 years at baseline. Incidence rates of all comorbidities assessed during follow-up were higher in the MG cohort than in controls. Almost two-thirds of MG patients experienced ≥1 myasthenic exacerbation during follow-up; incidence rates (95% confidence interval) of MG exacerbations and crises were 50.0 (44.7-55.9) and 1.3 (0.8-2.0) per 100 person-years, respectively. Visits to non-neurology specialists and outpatient clinics were the most common instances of HCRU overall, each being more frequent in the MG cohort than for controls. In the first year of follow-up, acetylcholinesterase inhibitors (AChEIs) and corticosteroids were used by 56.0% and 50.2% of MG patients, respectively; the use of AChEIs declined thereafter.
Conclusions: Despite treatment, there is a high disease burden for patients with newly diagnosed MG in England, with high rates of MG exacerbation and HCRU use. Thus, there is a need for targeted treatments with sustained efficacy and improved safety to adequately manage MG symptoms and reduce MG-related disease burden.
Date
2025-01-01
Type
Article
Subject
Health care rationing, Cost of illness, Neuromuscular diseases, Myasthenia gravis, Autoimmune diseases
Collections
Citation
Bonar K, Boudiaf N, Zaremba P, Tarancón T, Zhou J, Jacob S. Disease burden, healthcare resource utilisation, and treatment patterns in patients with newly diagnosed myasthenia gravis in England: A retrospective cohort study. J Neuromuscul Dis. 2025 Jan-Feb;12(1):22143602241308194. doi: 10.1177/22143602241308194.
Journal / Source Title
Journal of Neuromuscular Diseases
DOI
10.1177/22143602241308194
PMID
39973446
Publisher
SAGE Publications
Publisher’s URL
https://journals.sagepub.com/home/JND
http://content.iospress.com/journals/journal-of-neuromuscular-diseases
http://content.iospress.com/journals/journal-of-neuromuscular-diseases