Economic Burden of Illness Among Commercially Insured Patients with Systemic Sclerosis with Interstitial Lung Disease in the USA: A Claims Data Analysis

This study assessed and compared healthcare resource utilization (HRU), direct healthcare costs, work loss, and indirect costs between patients with SSc-ILD and matched controls with neither SSc nor ILD in the USA.MethodsData were obtained from a large US commercial claims database (2005 –2015). Patients (at least 18 years old) had at least one SSc diagnosis in the inpatient (IP) or emergency room (ER) setting or at least two SSc diagnoses in another setting, and at least one diagnosis of ILD in the IP or ER setting or at least two diagnoses of ILD in another setting. Controls wi th neither SSc nor ILD were matched 5:1 to patients with SSc-ILD. Comparisons were conducted using Wilcoxon signed-rank and McNemar’s tests and adjusted odds ratios (ORs) and incidence rate ratios (IRRs).ResultsA total of 479 SSc-ILD patients and 2395 matched controls were included (52 SSc-ILD patients and 260 matched controls for work loss and indirect cost analyses). Patients with SSc-ILD had significantly higher HRU and costs, IP admissions (adjusted IRR  = 5.6), IP hospitalization days (adjusted IRR = 12.0), ER visits (adjusted IRR = 2.8), OP visits (adjusted IRR = 3.1), and days of work loss (adjusted IRR = 4.5). The adjusted difference in annual direct healthcare costs was $28,632 (SSc-ILD, $33,195; controls, $4562) and that i n indirect costs was $4735 (SSc-ILD, $5640; controls, $906) (allp 
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research

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ConclusionYounger age of onset and high prevalence of Scl-70 antibody are unique South Asian features common with large Indian, Thai, and Chinese series. High prevalence of ILD is a feature common to Indian and Chinese series. Strong correlation of Scl-70 antibody with younger age and pulmonary hypertension were unique features of our cohort.Key Points• Asian Indian scleroderma patients are younger by 2 decades compared to Caucasian series.• Higher prevalence of Scl-70 antibody, its association with young age, interstitial lung disease and pulmonary hypertension are features of our cohort.•High prevalence of...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
Systemic sclerosis (SSc) is a rare disease characterized by widespread collagen deposition resulting in fibrosis. Although skin involvement is the most common manifestation and also the one that determines the classification of disease, mortality in SSc is usually a result of respiratory compromise in the form of interstitial lung disease (ILD) or pulmonary hypertension (PH). Clinically significant ILD is seen in up to 40% of patients and PH in up to 20%. Treatment with either cyclophosphamide or mycophenolate has been shown to delay disease progression, whereas rituximab and lung transplantation are reserved for refractory cases.
Source: Clinics in Chest Medicine - Category: Respiratory Medicine Authors: Source Type: research
CONCLUSION: In conclusion, in spite of a great deal of work supporting the potential role of LUS for the assessment of ILD-SSc too much remains to be done to validate its use as an outcome measure in ILD-SSc. PMID: 31263075 [PubMed - as supplied by publisher]
Source: Journal of Rheumatology - Category: Rheumatology Tags: J Rheumatol Source Type: research
A study of nintedanib in patients with ILD associated with systemic sclerosis showed the treatment had only limited improvement. Although these patients had a lower rate of decline in forced vital capacity than those on placebo, nintedanib did not result in clinical benefits for other manifestations of systemic sclerosis...
Source: The Rheumatologist - Category: Rheumatology Authors: Tags: Conditions Source Type: research
Lung diffusing capacity for nitric oxide may be of clinical value in systemic sclerosis because more sensitive to interstitial lung disease than standard lung diffusing capacity for carbon monoxide. AbstractA decreased lung diffusing capacity for carbon monoxide (DLCO) in systemic sclerosis (SSc) is considered to reflect losses of alveolar membrane diffusive conductance for CO (DMCO), due to interstitial lung disease, and/or pulmonary capillary blood volume (VC), due to vasculopathy. However, standard DLCO does not allow separate DMCO from VC. Lung diffusing capacity for nitric oxide (DLNO) is considered to be more sensiti...
Source: Physiological Reports - Category: Physiology Authors: Tags: Original Research Source Type: research
Conclusions: In our study cohort, the majority of which were dcSSc subtype with pATA, it was found that the presence of SSc-specific autoantibodies was associated with a distinctive clinical presentation and cumulative internal organ involvement, even in the early phase of the disease. Cardiopulmonary complications were rarely seen in the pACA group; whereas ILD complications were very common in both the pATA and nATA groups. A further study into the association of autoantibodies in nATA patients with ILD complications is needed. PMID: 31236172 [PubMed]
Source: Clin Med Res - Category: Research Authors: Tags: J Clin Med Res Source Type: research
AbstractObjectiveTo investigate the relationship between Krebs von den Lungen ‐6 [KL‐6] and CC chemokine ligand 2 [CCL‐18]) with severity and progression of systemic sclerosis‐related interstitial lung disease (SSc‐ILD).MethodsPatients enrolled in Scleroderma Lung Study (SLS) II (cyclophosphamide [CYC] versus mycophenolate mofetil [MMF]) were included. Baseline and 12 ‐month plasma samples were analyzed by ELISA to assess CCL‐18 and KL‐6 levels. The forced vital capacity (FVC) and the diffusing capacity for carbon monoxide (DLCO) were measured every 3 months. Joint models were created to investigate the rel...
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: Full Length Source Type: research
ConclusionIn a large cohort of patients with SSc ‐associated ILD, a significant proportion of patients had coexisting PH, which often occurs early after SSc diagnosis. Most patients were treated with ILD and PAH therapies, and survival was good. Patients with SSc‐associated ILD should be evaluated for coexisting PH.
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: Original Article Source Type: research
This study reveals that patients with ILD-SSc associated with chest HRCT evidence of PPFE require close and recurrent follow-up with periodic evaluation of lung function parameters, DLCO and chest HRCT. Rheumatologists should be aware of this new radiological finding which is accompanied by a negative prognosis, especially when associated with a progressive course. Patients with this radiological pattern need to be monitored with particular attention.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Publication date: Available online 31 May 2019Source: Pharmacology &TherapeuticsAuthor(s): Adelle S. Jee, Joanne Sahhar, Peter Youssef, Jane Bleasel, Stephen Adelstein, Maianh Nguyen, Tamera J. CorteAbstractDisease behaviour in interstitial lung disease (ILD) is highly variable and accurate clinical tools to predict prognosis and guide management decisions remain unsatisfactorily elusive. Accurate disease stratification would allow clinicians to better distinguish patients at risk of rapid progression requiring urgent treatment, from those indolent disease where potentially toxic drug therapy could be minimised or avoi...
Source: Pharmacology and Therapeutics - Category: Drugs & Pharmacology Source Type: research
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