Epidemiology and treatment of myasthenia gravis: a retrospective study using a large insurance claims dataset in Germany.

Myasthenia gravis (MG) is a rare, chronic autoimmune disease with symptoms of fluctuating muscular weakness and fatigability. The aim of this retrospective cohort study was to estimate the prevalence and incidence of MG in Germany, and to understand the burden of disease and treatment patterns, based on anonymized German claims data. Two patient samples were identified: (1) incident MG patients with newly onset disease between 2015 and 2019, and (2) prevalent MG patients in 2019. In total, 775 incident MG patients with a mean age of 66.9 years; and 1,247 prevalent MG patients with a mean age of 68.6 years were included. The prevalence for Germany was estimated to be 39.3/100,000 on 31/12/2019; the incidence in 2019 was 4.6 cases/100,000 persons. The 12-month mortality was 5.7. For 31.5% of the incident patients, no MG treatment was observed in the first year after the index date. Of all incident patients, 29.9% experienced an exacerbation, and 6.7% a myasthenic crisis during the observation. Our study indicates that a substantial proportion of MG patients remains untreated. Many MG patients still experience exacerbations / MG crises. MG seems to be associated with an excess mortality in comparison to the general non-MG population.

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Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest Antje Mevius participated in this study as an employee of Ingress-health HWM GmbH and has nothing to disclose. Lars Jöres, Jutta Biskup, Tanja Heidbrede are employees of UCB Pharma. Milada Mahic was an employee of UCB Pharma when this research was carried out and is now an employee of Vertex. Thomas Wilke is the director of IPAM and worked as an advisor for several pharmaceutical/consultancy companies. Ulf Maywald is an employee of AOK PLUS. Sophie Lehnerer has received speaker..s honoraria and honoraria for attendance at advisory boards from Alexion, argenx and UCB. Andreas Meisel received speaker honoraria, consulting fees or financial research support (for institution) from Alexion, argenx, Grifols, Hormosan, Janssen, Octapharma and UCB Pharma. He serves as chairman of the medical advisory board of the German Myasthenia Gravis Society.