The Annual Diagnostic Prevalence of Ankylosing Spondylitis and Axial Spondyloarthritis in the United States Using Medicare and MarketScan Databases
Objective The objective of this study was to investigate the diagnostic prevalence of ankylosing spondylitis (AS) and axial spondyloarthritis (axSpA) in the United States and examine treatment patterns for these diseases. Methods This retrospective observational cohort study drew from 2006‐2014 data...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-11-01
|
| Series: | ACR Open Rheumatology |
| Online Access: | https://doi.org/10.1002/acr2.11316 |
| _version_ | 1818824789021687808 |
|---|---|
| author | Jeffrey R. Curtis Kevin Winthrop Rhonda L. Bohn Robert Suruki Sarah Siegel Jeffrey L. Stark Fenglong Xie Huifeng Yun Lang Chen Atul Deodhar |
| author_facet | Jeffrey R. Curtis Kevin Winthrop Rhonda L. Bohn Robert Suruki Sarah Siegel Jeffrey L. Stark Fenglong Xie Huifeng Yun Lang Chen Atul Deodhar |
| author_sort | Jeffrey R. Curtis |
| collection | DOAJ |
| description | Objective The objective of this study was to investigate the diagnostic prevalence of ankylosing spondylitis (AS) and axial spondyloarthritis (axSpA) in the United States and examine treatment patterns for these diseases. Methods This retrospective observational cohort study drew from 2006‐2014 data in the US Medicare Fee‐for‐Service and IBM MarketScan databases. AS and axSpA diagnoses were identified through International Classification of Diseases, Ninth Revision [ICD‐9] codes. Diagnostic prevalence (per 10,000 patients) was calculated as patients with AS and axSpA with full insurance coverage in each calendar year divided by the total patients with full insurance coverage in the same year. Two diagnosis definitions were used: definition 1 (D1), one or more relevant ICD‐9 codes from hospital claims or two or more relevant ICD‐9 codes from outpatient claims; definition 2 (D2), one or more codes from hospital/outpatient claims. Primary analyses assessed annual AS and axSpA prevalence (D1); sensitivity analyses assessed annual (D2) and 2‐year prevalence. Patterns in prevalence and treatment use were analyzed descriptively; no statistical tests were performed. Results An increase in AS prevalence (per 10,000 patients) was seen from 2006 to 2014 in primary analyses (Medicare: 2.12‐3.60; MarketScan: 0.85‐1.42) and sensitivity analyses. A similar trend occurred for axSpA (Medicare: 4.39‐6.52; MarketScan: 1.33‐2.21). For Medicare, the proportion of patients with AS (D1) using tumor necrosis factor α inhibitors (TNFis), conventional synthetic antirheumatic drugs (csARDs), nonsteroidal antiinflammatory drugs (NSAIDs), opioids, and glucocorticoids remained relatively stable; for MarketScan, TNFi‐treated patients increased (51.7% to 65.7%) and NSAID‐treated patients decreased (63.5% to 55.7%). Conclusion AS and axSpA prevalence may have increased in the United States between 2006 and 2014. Reasons are unknown, but this may be due to increased disease awareness, among other factors. |
| first_indexed | 2024-12-19T00:01:27Z |
| format | Article |
| id | doaj.art-cdb27824a955451f8f3fd665c4e5edf8 |
| institution | Directory Open Access Journal |
| issn | 2578-5745 |
| language | English |
| last_indexed | 2024-12-19T00:01:27Z |
| publishDate | 2021-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | ACR Open Rheumatology |
| spelling | doaj.art-cdb27824a955451f8f3fd665c4e5edf82022-12-21T20:46:27ZengWileyACR Open Rheumatology2578-57452021-11-0131174375210.1002/acr2.11316The Annual Diagnostic Prevalence of Ankylosing Spondylitis and Axial Spondyloarthritis in the United States Using Medicare and MarketScan DatabasesJeffrey R. Curtis0Kevin Winthrop1Rhonda L. Bohn2Robert Suruki3Sarah Siegel4Jeffrey L. Stark5Fenglong Xie6Huifeng Yun7Lang Chen8Atul Deodhar9University of Alabama at BirminghamOregon Health & Science University PortlandUCB Pharma Smyrna GeorgiaUCB Pharma Smyrna GeorgiaOregon Health & Science University PortlandUCB Pharma Smyrna GeorgiaUniversity of Alabama at BirminghamUniversity of Alabama at BirminghamUniversity of Alabama at BirminghamOregon Health & Science University PortlandObjective The objective of this study was to investigate the diagnostic prevalence of ankylosing spondylitis (AS) and axial spondyloarthritis (axSpA) in the United States and examine treatment patterns for these diseases. Methods This retrospective observational cohort study drew from 2006‐2014 data in the US Medicare Fee‐for‐Service and IBM MarketScan databases. AS and axSpA diagnoses were identified through International Classification of Diseases, Ninth Revision [ICD‐9] codes. Diagnostic prevalence (per 10,000 patients) was calculated as patients with AS and axSpA with full insurance coverage in each calendar year divided by the total patients with full insurance coverage in the same year. Two diagnosis definitions were used: definition 1 (D1), one or more relevant ICD‐9 codes from hospital claims or two or more relevant ICD‐9 codes from outpatient claims; definition 2 (D2), one or more codes from hospital/outpatient claims. Primary analyses assessed annual AS and axSpA prevalence (D1); sensitivity analyses assessed annual (D2) and 2‐year prevalence. Patterns in prevalence and treatment use were analyzed descriptively; no statistical tests were performed. Results An increase in AS prevalence (per 10,000 patients) was seen from 2006 to 2014 in primary analyses (Medicare: 2.12‐3.60; MarketScan: 0.85‐1.42) and sensitivity analyses. A similar trend occurred for axSpA (Medicare: 4.39‐6.52; MarketScan: 1.33‐2.21). For Medicare, the proportion of patients with AS (D1) using tumor necrosis factor α inhibitors (TNFis), conventional synthetic antirheumatic drugs (csARDs), nonsteroidal antiinflammatory drugs (NSAIDs), opioids, and glucocorticoids remained relatively stable; for MarketScan, TNFi‐treated patients increased (51.7% to 65.7%) and NSAID‐treated patients decreased (63.5% to 55.7%). Conclusion AS and axSpA prevalence may have increased in the United States between 2006 and 2014. Reasons are unknown, but this may be due to increased disease awareness, among other factors.https://doi.org/10.1002/acr2.11316 |
| spellingShingle | Jeffrey R. Curtis Kevin Winthrop Rhonda L. Bohn Robert Suruki Sarah Siegel Jeffrey L. Stark Fenglong Xie Huifeng Yun Lang Chen Atul Deodhar The Annual Diagnostic Prevalence of Ankylosing Spondylitis and Axial Spondyloarthritis in the United States Using Medicare and MarketScan Databases ACR Open Rheumatology |
| title | The Annual Diagnostic Prevalence of Ankylosing Spondylitis and Axial Spondyloarthritis in the United States Using Medicare and MarketScan Databases |
| title_full | The Annual Diagnostic Prevalence of Ankylosing Spondylitis and Axial Spondyloarthritis in the United States Using Medicare and MarketScan Databases |
| title_fullStr | The Annual Diagnostic Prevalence of Ankylosing Spondylitis and Axial Spondyloarthritis in the United States Using Medicare and MarketScan Databases |
| title_full_unstemmed | The Annual Diagnostic Prevalence of Ankylosing Spondylitis and Axial Spondyloarthritis in the United States Using Medicare and MarketScan Databases |
| title_short | The Annual Diagnostic Prevalence of Ankylosing Spondylitis and Axial Spondyloarthritis in the United States Using Medicare and MarketScan Databases |
| title_sort | annual diagnostic prevalence of ankylosing spondylitis and axial spondyloarthritis in the united states using medicare and marketscan databases |
| url | https://doi.org/10.1002/acr2.11316 |
| work_keys_str_mv | AT jeffreyrcurtis theannualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT kevinwinthrop theannualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT rhondalbohn theannualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT robertsuruki theannualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT sarahsiegel theannualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT jeffreylstark theannualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT fenglongxie theannualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT huifengyun theannualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT langchen theannualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT atuldeodhar theannualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT jeffreyrcurtis annualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT kevinwinthrop annualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT rhondalbohn annualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT robertsuruki annualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT sarahsiegel annualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT jeffreylstark annualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT fenglongxie annualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT huifengyun annualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT langchen annualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases AT atuldeodhar annualdiagnosticprevalenceofankylosingspondylitisandaxialspondyloarthritisintheunitedstatesusingmedicareandmarketscandatabases |