Clinical and Economic Burden Associated with Chronic Hypoparathyroidism: A Retrospective Chart Review in the United States, Canada, United Kingdom, France, Germany, Italy, and Spain
Presentation Number: MON 347
Date of Presentation: April 3rd, 2017
Kristina Chen*1, Alan Krasner1, Nanxin Li2, Cheryl Q. Xiang2, Ariadne Souroutzidis2 and Jipan Xie3
1Shire Human Genetic Therapies, Inc., Lexington, MA, 2Analysis Group Inc., Boston, MA, 3Analysis Group Inc., Los Angeles, CA
Background: Chronic hypoparathyroidism (HPT) is a rare endocrine disorder that presents with low serum calcium and parathyroid hormone levels. Despite treatment with calcium and vitamin D, patients often continue to experience symptoms and comorbidities. This study aimed to assess clinical and economic burden associated with chronic HPT.
Methods: This retrospective chart review examined adult patients with chronic HPT (defined as duration of HPT ≥1 year) who received calcium and vitamin D and were treated by endocrinologists in the US, Canada, UK, France, Germany, Italy, and Spain. The study period was one year before the date of chart review. Patient demographics, disease characteristics, treatment, symptoms, comorbidities, and HPT-related healthcare resource utilization (HRU) during the study period were described. HPT-related healthcare costs (in 2015 currency) in each country were estimated by applying the unit costs identified from public data sources to the HPT-related HRU. Patients with uncontrolled HPT were identified based on lab, treatment, or persistent symptoms. The comorbidities and HPT-related HRU were compared between uncontrolled and controlled patients.
Results: Among a total of 614 patients with chronic HPT, mean age was 43.6 years (SD 14.8 years), the majority were female (61.6%), Caucasian (78.8%), and acquired HPT post-surgically (74.4%). Mean duration of HPT was 3.8 years (SD 4.7 years). Calcium carbonate and calcitriol were the most-commonly used oral calcium supplement and vitamin D treatment. Symptoms of HPT were reported in 59.4% of the patients, with physical symptoms such as fatigue (33.6%) and muscle cramping (23.1%) being the most frequently reported ones. Comorbidities were present in 46.7% of the patients, with calcium/phosphate imbalances (21.2%), cardiovascular and metabolic disorders (20.2%), and neuropsychiatric disorders (16.8%) being most prevalent. Most of the patients (90.7%) had at least one HPT-related HRU during the prior 1-year study period: 19.5% of the patients had at least one inpatient hospitalization (IP), 41% at least one emergency room visit, and 87.8% at least one outpatient (OP) visit. About 39.3% of the patients had at least one specialist visit.
Compared with controlled patients (N=361), uncontrolled patients (N=253) experienced significantly increased comorbidities (56.9% vs. 39.6%), particularly calcium/phosphate imbalances, neuropsychiatric, and renal disorders (all P<0.01), and significantly more HPT-related IP and OP visits (both P<0.01).
Conclusions: This chart review showed that despite treatment with calcium and vitamin D, chronic HPT, particularly uncontrolled HPT, was associated with substantial clinical and economic burden.
Disclosure: KC: Employee, Shire. AK: Employee, Shire. NL: Consultant, Shire. CQX: Consultant, Shire. AS: Consultant, Shire. JX: Consultant, Shire.