Characteristics and management of giant cell arteritis in France: a study based on national health insurance claims data

Author:

Mahr Alfred1,Belhassen Manon2,Paccalin Marc3,Devauchelle-Pensec Valérie4,Nolin Maeva2,Gandon Sophie5,Idier Isabelle6,Hachulla Eric7

Affiliation:

1. Internal Medicine, Hospital Saint-Louis, University Paris Diderot, Paris, France

2. Pelyon EA 7425, University Hospital Lyon, Lyon, France

3. Internal Medicine, University Hospital Poitiers, Poitiers, France

4. Rheumatology, University Hospital Brest, UMR 1227, Brest, France

5. Clinical Operations France, Roche S.A.S., Boulogne-Billancourt, France

6. Rheumatology Medical, Chugai Pharma France, Paris La Défense, France

7. Internal Medicine and Clinical Immunology, CHU Lille, University Lille, LIRIC, INSERM, Lille, France

Abstract

Abstract Objective Few data are available on the epidemiology and management of GCA in real life. We aimed to address this situation by using health insurance claims data for France. Methods This retrospective study used the Echantillon Généraliste de Bénéficiaires (EGB) database, a 1% representative sample of the French national health insurance system. The EGB contains anonymous data on long-term disease status, hospitalizations and reimbursement claims for 752 717 people. Data were collected between 2007 and 2015. The index date was defined as the date of the first occurrence of a GCA code. Demographics, comorbidities, diagnostic tests and therapies were analysed. Annual incidence rates were calculated, and incident and overall GCA cases were studied. Results We identified 241 patients with GCA. The annual incidence was 7–10/100 000 people ⩾50 years old. Among the 117 patients with incident GCA, 74.4% were females, with mean age 77.6 years and mean follow-up 2.2 years. After the index date, 51.3% underwent temporal artery biopsy and 29.1% high-resolution Doppler ultrasonography. Among the whole cohort, 84.3% used only glucocorticoids. The most-prescribed glucocorticoid-sparing agent was methotrexate (12.0%). Conclusion The incidence of GCA in France is 7–10/100 000 people ⩾ 50 years old. Adjunct agents, mainly methotrexate, are given to only a few patients. The use of temporal artery biopsy in only half of the patients might reflect a shift toward the use of imaging techniques to diagnose GCA.

Funder

Roche SAS and Chugai Pharma France

Publisher

Oxford University Press (OUP)

Subject

Pharmacology (medical),Rheumatology

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