ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.
Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.
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Increased Co-Occurring Prescriptions of Gastrointestinal and Respiratory Drugs Among Persons with Ehlers-Danlos Syndromes
Session Title
TP65 - TP065 ENVIRONMENTAL EXPOSURES AND LUNG DISEASE
Abstract
A3135 - Increased Co-Occurring Prescriptions of Gastrointestinal and Respiratory Drugs Among Persons with Ehlers-Danlos Syndromes
Author Block: R. Dhingra1, R. Bascom2, E. Thompson3, C. A. Francomano4, J. R. Schubart5; 1Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States, 2MS Hershey Medical Ctr, Penn State Univ, Hershey, PA, United States, 3Medicine, Penn State College of Medicine, Hershey, PA, United States, 4Medical and Molecular Genetics, Indiana University College of Medicine, Indianapolis, IN, United States, 5Surgery, Penn State College of Medicine, Hershey, PA, United States.
Rationale: An increased prevalence of aerodigestive symptoms such as chronic nasal congestion, vocal cord abnormalities, swallowing difficulties, globus sensation, throat tightness, asthma, and dyspepsia have been reported among people with the Ehlers-Danlos Syndromes (EDS). We previously reported higher individual burdens of gastrointestinal (GI) and respiratory medications among persons with EDS compared to matched controls. However, the burden of co-occurring GI and respiratory drug prescriptions among persons with EDS is unknown. We hypothesized a higher burden of co-occurring GI and respiratory medications among persons with EDS compared to matched controls, and a peripubertal increase in these prescriptions among women with EDS based on our prior studies.
Methods: We used 10 years (2005-2014) of prescription claims data to compare co-occurring GI and respiratory drug prescription claims among persons with EDS (N=4294; ages 5-62) against their age-, sex-, state of residence-, and earliest claim date-matched controls. All included subjects had to be continuously enrolled for two years from the earliest claim date in a MarketScan covered insurance plan. We defined co-occurring GI and respiratory medication as at least one GI and one respiratory medication at any point during an individual’s two-year observation window.
Results: Our cohort averaged 30 years old, was 66% female, and 71% persons ages ≥18 years. At least one respiratory medication was prescribed for 60.2% of persons with EDS and 39.1% controls. Compared to 10% controls, 29% persons with EDS had co-occurring prescription claims for GI and respiratory medications (P<0.0001). Women with EDS had higher co-occurring prescriptions compared to controls (34% vs. 12%; P<0.0001) and showed a peripubertal increase in these prescriptions (see Figure). Proportions of only respiratory drugs prescriptions were similar among persons with EDS and controls (31% vs. 29%); but proportions of only GI drugs were higher among persons with EDS compared to controls (9.5% vs. 7%).
Conclusions: A higher co-occurring GI and respiratory medication burden among persons with EDS underscores the increased prevalence of aerodigestive symptoms among persons with EDS and a need to focus on the pathogenesis and clinical evaluation of EDS-specific aerodigestive disorders. The peripubertal increase of co-occurring GI and respiratory prescriptions among females with EDS adds to the evidence of peripubertal amplification of EDS disease burden among peripubertal females and suggests a critical time window. The development of protocols for timely identification and treatment of aerodigestive symptoms could offer an opportunity to reduce disease burden in this vulnerable patient population who experience multiple co-morbidities.
Author Block: R. Dhingra1, R. Bascom2, E. Thompson3, C. A. Francomano4, J. R. Schubart5; 1Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States, 2MS Hershey Medical Ctr, Penn State Univ, Hershey, PA, United States, 3Medicine, Penn State College of Medicine, Hershey, PA, United States, 4Medical and Molecular Genetics, Indiana University College of Medicine, Indianapolis, IN, United States, 5Surgery, Penn State College of Medicine, Hershey, PA, United States.
Rationale: An increased prevalence of aerodigestive symptoms such as chronic nasal congestion, vocal cord abnormalities, swallowing difficulties, globus sensation, throat tightness, asthma, and dyspepsia have been reported among people with the Ehlers-Danlos Syndromes (EDS). We previously reported higher individual burdens of gastrointestinal (GI) and respiratory medications among persons with EDS compared to matched controls. However, the burden of co-occurring GI and respiratory drug prescriptions among persons with EDS is unknown. We hypothesized a higher burden of co-occurring GI and respiratory medications among persons with EDS compared to matched controls, and a peripubertal increase in these prescriptions among women with EDS based on our prior studies.
Methods: We used 10 years (2005-2014) of prescription claims data to compare co-occurring GI and respiratory drug prescription claims among persons with EDS (N=4294; ages 5-62) against their age-, sex-, state of residence-, and earliest claim date-matched controls. All included subjects had to be continuously enrolled for two years from the earliest claim date in a MarketScan covered insurance plan. We defined co-occurring GI and respiratory medication as at least one GI and one respiratory medication at any point during an individual’s two-year observation window.
Results: Our cohort averaged 30 years old, was 66% female, and 71% persons ages ≥18 years. At least one respiratory medication was prescribed for 60.2% of persons with EDS and 39.1% controls. Compared to 10% controls, 29% persons with EDS had co-occurring prescription claims for GI and respiratory medications (P<0.0001). Women with EDS had higher co-occurring prescriptions compared to controls (34% vs. 12%; P<0.0001) and showed a peripubertal increase in these prescriptions (see Figure). Proportions of only respiratory drugs prescriptions were similar among persons with EDS and controls (31% vs. 29%); but proportions of only GI drugs were higher among persons with EDS compared to controls (9.5% vs. 7%).
Conclusions: A higher co-occurring GI and respiratory medication burden among persons with EDS underscores the increased prevalence of aerodigestive symptoms among persons with EDS and a need to focus on the pathogenesis and clinical evaluation of EDS-specific aerodigestive disorders. The peripubertal increase of co-occurring GI and respiratory prescriptions among females with EDS adds to the evidence of peripubertal amplification of EDS disease burden among peripubertal females and suggests a critical time window. The development of protocols for timely identification and treatment of aerodigestive symptoms could offer an opportunity to reduce disease burden in this vulnerable patient population who experience multiple co-morbidities.
