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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Respiratory Prescription Claims Among Persons with Ehlers-Danlos Syndromes Over Multiple Time Intervals
Session Title
TP65 - TP065 ENVIRONMENTAL EXPOSURES AND LUNG DISEASE
Abstract
A3128 - Respiratory Prescription Claims Among Persons with Ehlers-Danlos Syndromes Over Multiple Time Intervals
Author Block: R. Dhingra1, J. R. Schubart2, C. A. Francomano3, R. Bascom4; 1Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States, 2Surgery, Penn State College of Medicine, Hershey, PA, United States, 3Medical and Molecular Genetics, Indiana University College of Medicine, Indianapolis, IN, United States, 4MS Hershey Medical Ctr, Penn State Univ, Hershey, PA, United States.
Rationale: Despite a clinical impression of high respiratory symptom prevalence among people with Ehlers-Danlos Syndromes (EDS), there are limited data regarding upper and lower airway conditions in EDS. The differential diagnosis for respiratory symptoms among persons with EDS includes structural, functional, and inflammatory causes. Using prescription claims data, we previously showed that the respiratory medication prescriptions among persons with EDS compared to matched controls were increased at the two-year window from their earliest claim date. It is unknown whether looking at shorter time frames would have similar respiratory prescription prevalence patterns among persons with EDS compared to their matched controls.
Methods: We compared the number of persons with EDS receiving respiratory drug prescription claims (N=4294; ages 5-62) at 3-, 6-, 12-, and 24-month intervals from their earliest claim date against their age-, sex-, state of residence-, and earliest claim date-matched controls (N=4294). We used 10 years (2005-2014) of private prescription claims data from a MarketScan database. Data on over-the-counter and non-pharmacologic interventions were not available.
Results: The mean age of our cohort was 30 years with 71% female and 66% adults (≥18 years). Our data indicated that people with EDS were twice as likely to receive prescriptions for short-acting beta agonists (SABAs), as well as a combination of SABAs and intranasal/inhaled corticosteroids (ICS), at all four-time intervals (Figure). Compared to matched controls, we observed that persons with EDS were also two-to-three times more likely to receive prescriptions for other respiratory drug combinations, such as SABAs and H1-antihistamines (H1); ICS and H1; SABAs and oral steroids; H1 and oral steroids; ICS and oral steroids; and SABAs/ICS/oral steroids, at all four-time intervals. All results were statistically significant at P<0.0001.
Conclusions: Although we are cautious in extending the increased prescription rates to any specific respiratory diagnoses, higher respiratory prescription claims among persons with EDS compared to matched controls indicate that respiratory symptoms are a common co-morbidity in EDS. Comprehensive respiratory histories should be obtained among persons with EDS. Additionally, diagnostic algorithms need to be developed and evaluated to distinguish among the possible causes of EDS-specific respiratory diagnoses. Moreover, it is critical to determine whether these medications are effective in reducing the burden of respiratory symptoms among persons with EDS.
Author Block: R. Dhingra1, J. R. Schubart2, C. A. Francomano3, R. Bascom4; 1Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States, 2Surgery, Penn State College of Medicine, Hershey, PA, United States, 3Medical and Molecular Genetics, Indiana University College of Medicine, Indianapolis, IN, United States, 4MS Hershey Medical Ctr, Penn State Univ, Hershey, PA, United States.
Rationale: Despite a clinical impression of high respiratory symptom prevalence among people with Ehlers-Danlos Syndromes (EDS), there are limited data regarding upper and lower airway conditions in EDS. The differential diagnosis for respiratory symptoms among persons with EDS includes structural, functional, and inflammatory causes. Using prescription claims data, we previously showed that the respiratory medication prescriptions among persons with EDS compared to matched controls were increased at the two-year window from their earliest claim date. It is unknown whether looking at shorter time frames would have similar respiratory prescription prevalence patterns among persons with EDS compared to their matched controls.
Methods: We compared the number of persons with EDS receiving respiratory drug prescription claims (N=4294; ages 5-62) at 3-, 6-, 12-, and 24-month intervals from their earliest claim date against their age-, sex-, state of residence-, and earliest claim date-matched controls (N=4294). We used 10 years (2005-2014) of private prescription claims data from a MarketScan database. Data on over-the-counter and non-pharmacologic interventions were not available.
Results: The mean age of our cohort was 30 years with 71% female and 66% adults (≥18 years). Our data indicated that people with EDS were twice as likely to receive prescriptions for short-acting beta agonists (SABAs), as well as a combination of SABAs and intranasal/inhaled corticosteroids (ICS), at all four-time intervals (Figure). Compared to matched controls, we observed that persons with EDS were also two-to-three times more likely to receive prescriptions for other respiratory drug combinations, such as SABAs and H1-antihistamines (H1); ICS and H1; SABAs and oral steroids; H1 and oral steroids; ICS and oral steroids; and SABAs/ICS/oral steroids, at all four-time intervals. All results were statistically significant at P<0.0001.
Conclusions: Although we are cautious in extending the increased prescription rates to any specific respiratory diagnoses, higher respiratory prescription claims among persons with EDS compared to matched controls indicate that respiratory symptoms are a common co-morbidity in EDS. Comprehensive respiratory histories should be obtained among persons with EDS. Additionally, diagnostic algorithms need to be developed and evaluated to distinguish among the possible causes of EDS-specific respiratory diagnoses. Moreover, it is critical to determine whether these medications are effective in reducing the burden of respiratory symptoms among persons with EDS.
