POS0024 ESTIMATED PREVALENCE, INCIDENCE AND HEALTHCARE COSTS OF SJÖGREN’S SYNDROME IN FRANCE: A NATIONAL CLAIMS-BASED STUDY
Authors: R. Seror, L. Chiche, G. Desjeux, J. Zhuo, B. Bregman, V. Vannier-Moreau, V. Devauchelle-Pensec
Journal: Annals of the Rheumatic Diseases (2021)

Background: Sjögren’s syndrome (SS) is a chronic, systemic autoimmune disorder characterised by oral and ocular dryness related to lymphocytic infiltration of exocrine glands. 1–3 Extra-glandular manifestations may include fatigue, musculoskeletal pain and glomerulonephritis. 1,3 SS can present as primary SS (pSS) or as SS associated with another autoimmune disorder (SS+AID). 1 Reported prevalence of pSS in the French general population is 1.02–1.52 cases/10,000 people. 3 Objectives: To estimate prevalence, incidence and healthcare costs of SS in France using national health insurance claims data. Methods: Claims from 2011–2018 from the Système National des Données de Santé (SNDS), comprised of data from 99% of the French population, were analysed. Patients (pts) with SS were identified using an algorithm. 4 Inclusion criteria: International Classification of Diseases, Tenth Revision code M35.0 (Sicca syndrome [Sjögren]) or M35 (other systemic involvement of connective tissue), and ≥2 drug reimbursements for SS-related treatments. Key exclusion criteria: amyloidosis, sarcoidosis, HIV, and head and neck radiotherapy. Denominators for estimated prevalence rates were derived from French population census data. Healthcare costs were based on Assurance Maladie rates. Results: 23,152 pts with pSS and 15,462 with SS+AID were identified during the study period. Estimated prevalence of SS (2011–2018) per 100,000 persons ranged from 22–32 (pSS) and 17–22 (SS+AID) and was stable over time; proportion of female pts was 90–91% (pSS) and 92–93% (SS+AID); mean age ranged from 63–66 (pSS) and 58–63 (SS+AID) years. Estimated incidence of SS (2012–2018) per 100,000 persons ranged from 4.1–0.3 (pSS) and 2.1–0.1 (SS+AID); proportion of female pts was 76–87% (pSS) and 74–90% (SS+AID); mean age ranged from 53–64 (pSS) and 50–62 (SS+AID) years. RA was the most frequently associated autoimmune disorder (32%) in pts with SS+AID. In the first year, artificial tears was the most frequently reimbursed drug (66% [pSS], 55% [SS+AID]), followed by hydroxychloroquine (19% [pSS], 35% [SS+AID]). From 2014–2018, ~30% of men and ~22% of women with pSS reported no drug reimbursement; ~20% of men and ~15% of women with SS+AID reported no drug reimbursement during the same time frame. From 2013–2018, ~50% of all pts had consultations with a dentist or an ophthalmologist. Mean healthcare costs increased over the study period: from €5836 to €9618 (pSS) and €8905 to €13,271 (SS+AID). Pt characteristics and healthcare consumption data are presented (Table 1). Conclusion: Prevalence of pSS in this French claims data study was stable over time and consistent with previous reports. 3 Based on these results, SS may be considered an orphan disease. Overall costs for pts with SS were higher than previously estimated. 5 Results may help inform and optimise specialist care for pts with SS in France. References: [1]Patel R, Shahane A. Clin Epidemiol 2014;6:247–255. [2]Mariette X, Criswell LA. N Engl J Med 2018;378:931–939. [3]Maldini C, et al. Arthritis Care Res (Hoboken ) 2014;66:454–463. [4]Devauchelle Pensec V, et al. Arthritis Rheumatol 2019;71(suppl 10):abstract 1101. [5]l’Assurance Maladie. Améliorer la qualité du système de santé et maîtriser les dépenses. July 2019. Table 1. Characteristics and healthcare consumption data for pts with SS in the SNDS (2011–2018) pSS SS+AID Age at disease onset, overall and by sex M (n=2515 ) F (n=20,637 ) All (n=23,152 ) M (n=1350 ) F (n=14,112 ) All (n=15,462 ) Mean (SD ) 62 (15) 60 (15) 60 (15) 59 (14) 56 (15) 56 (15) Age, yrs, n (% ) &lt;50 480 (19) 4948 (24) 5428 (23) 328 (24) 4507 (32) 4835 (31) 50–74 1471 (59) 11,567 (56) 13,038 (56) 852 (63) 7887 (56) 8739 (57) ≥75 564 (22) 4122 (20) 4686 (20) 170 (13) 1718 (12) 1888 (12) Healthcare consumption Mean (IQR) no. prescriptions for treatment of interest 37 (9–58) 52 (20–78) ≥1 Schirmer’s test, n (%) 2409 (10) 1303 (8) Reimbursement for antinuclear antibody test, n (%) 13,312 (58) 9587 (62) Mean no. dental reimbursements/yr 2 1 Mean no. ophthalmologist reimbursements/yr 1 1 F=female; IQR=interquartile range; M=male; yr=year. Acknowledgements: This study was sponsored by Bristol Myers Squibb. Professional medical writing assistance was provided by Lindsay Craik at Caudex and was funded by Bristol Myers Squibb. Disclosure of Interests: Raphaèle Seror Consultant of: Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Fresenius Kabi, GlaxoSmithKline, Janssen, Pfizer, Roche, Laurent Chiche: None declared, Guillaume Desjeux: None declared, Joe Zhuo Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Bruno Bregman Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Virginie Vannier-Moreau Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Valerie Devauchelle-Pensec Consultant of: AbbVie, Bristol Myers Squibb, Novartis, Grant/research support from: Bristol Myers Squibb, Lilly, Roche-Chugai.