Inhibitor clinical burden of disease: a comparative analysis of the CHESS data
Affiliation
Outcomes Research & Epidemiology, Shire, Massachusetts; HCD Economics, Daresbury; University of Chester; Shire, SwitzerlandPublication Date
2018-11-09
Metadata
Show full item recordAbstract
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 (N = 139) 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 (mean ± standard deviation, 8.29 ± 9.18 vs 3.72 ± 3.95; p < .0001) and joint bleeds (2.17 ± 1.90 vs 0.98 ± 1.15; p < .0001), and required more hemophilia-related (mean ± standard deviation, 1.79 ± 1.83 vs 0.64 ± 1.13) and bleed-related hospitalizations (1.86 ± 1.88 vs 0.81 ± 1.26), hemophilia-related consultations (9.30 ± 4.99 vs 6.77 ± 4.47), and outpatient visits (22.09 ± 17.77 vs 11.48 ± 16.00) (all, p < .001). More than one-half (53.5%) experienced moderate/severe pain necessitating medication compared to one-third (32.8%) of patients without inhibitors (p = .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.Citation
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/s13023-018-0929-9Publisher
BMCAdditional Links
https://ojrd.biomedcentral.com/articles/10.1186/s13023-018-0929-9Type
ArticleEISSN
1750-1172ae974a485f413a2113503eed53cd6c53
10.1186/s13023-018-0929-9