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Inhibitor clinical burden of disease: a comparative analysis of the CHESS data
Oladapo, Abiola Lu, Mei Walsh, Shaun O'Hara, Jamie Kauf, Teresa L.
Oladapo, Abiola
Lu, Mei
Walsh, Shaun
O'Hara, Jamie
Kauf, Teresa L.
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2018-11-09
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Abstract
BACKGROUND: Patients with hemophilia and inhibitors generally face greater disease burden compared to patients without inhibitors. While raising awareness of relative burden may improve the standard of care for patients with inhibitors, comparative data are sparse. Analyzing data drawn from the Cost of Haemophilia across Europe - a Socioeconomic Survey (CHESS) study, the aim of this study was to compare the clinical burden of disease in patients with severe hemophilia with and without inhibitors. Hemophilia specialists (Nā=ā139) across five European countries completed an online survey between January-April 2015, providing demographic, clinical and 12-month ambulatory/secondary care activity data for 1285 patients. Patients with hemophilia who currently presented with inhibitors and those who never had inhibitors were matched on baseline characteristics via propensity score matching. Outcomes were compared between the two cohorts using a paired t-test or Wilcoxon signed-rank or McNemar's test. RESULTS:The proportion of patients who currently presented with inhibitors was 4.5% (58/1285). Compared to PS-matched patients without inhibitors, patients with inhibitors experienced more than twice the mean annual number of bleeds (meanāĀ±āstandard deviation, 8.29āĀ±ā9.18 vs 3.72āĀ±ā3.95; pā<ā.0001) and joint bleeds (2.17āĀ±ā1.90 vs 0.98āĀ±ā1.15; pā<ā.0001), and required more hemophilia-related (meanāĀ±āstandard deviation, 1.79āĀ±ā1.83 vs 0.64āĀ±ā1.13) and bleed-related hospitalizations (1.86āĀ±ā1.88 vs 0.81āĀ±ā1.26), hemophilia-related consultations (9.30āĀ±ā4.99 vs 6.77āĀ±ā4.47), and outpatient visits (22.09āĀ±ā17.77 vs 11.48āĀ±ā16.00) (all, pā<ā.001). More than one-half (53.5%) experienced moderate/severe pain necessitating medication compared to one-third (32.8%) of patients without inhibitors (pā=ā.01). CONCLUSIONS:Patients with hemophilia and inhibitors exhibited greater clinical burden and higher resource utilization compared to their peers without inhibitors. Strategies for improving the standard of care may alleviate burden in this population.
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Oladapo, A., Lu, M., Walsh, S., O'Hara, J., & Kauf, T. L. (2018). Inhibitor clinical burden of disease: a comparative analysis of the CHESS data. Orphanet Journal of Rare Diseases, 13(1), 198. https://doi.org/10.1186/s13023-018-0929-9
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BioMed Central
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Orphanet Journal of Rare Diseases
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1750-1172