Myasthenia Gravis in Poland: National Healthcare Database Epidemiological Study

Abstract

Introduction: Myasthenia gravis (MG) is a rare autoimmune disorder of the neuromuscular junction. MG epidemiology has not been studied in Poland in a nationwide study before. Methods: Our epidemiological data were drawn from the National Health Fund (Narodowy Fundusz Zdrowia, NFZ) database; an MG patient was defined as a person who received at least once medical service coded in ICD-10 as MG (G70) and at least 2 reimbursed prescriptions for pyridostigmine bromide (Mestinon®) or ambenonium chloride (Mytelase®) in 2 consecutive years. Results: On 1st of January 2019, 8,702 patients with MG were receiving symptomatic treatment (female:male ratio: 1.65:1). MG incidence was 2.36/100,000. The mean age of incident cases in 2018 was 61.37 years, 59.17 years for women and 64.12 years for men. Incidence of early-onset MG (<50 years) was 0.80/100,000 and 4.98/100,000 for late-onset MG (LOMG), with male predominance in LOMG. Prevalence was 22.65/100,000. In women, there was a constant increase in prevalence of symptomatic MG from the first decade of life up to 80–89 years. In men, an increase in prevalence appeared in the 6th decade. The highest prevalence was observed in the age group of 80–89 years: 59.65/100,000 in women and 96.25/100,000 in men. Conclusions: Our findings provide information on epidemiology of MG in Poland and can serve as a tool to evaluate healthcare resources needed for MG patients.

Incidence, Prevalence, Hospitalization Rates, and Treatment Patterns in Myasthenia Gravis: A 10-Year Real-World Data Analysis of German Claims Data

“…Our data also shows that the IR for females in early-onset MG is higher than that in male patients, whereas late-onset MG is more common in males. This bimodal distribution was observed in 5 of 14 studies by Carr et al [4] and in a Polish cohort [18]. The absolute gender ratio, however, showed a male predominance for incidence and prevalence.…”

Incidence, Prevalence, Hospitalization Rates, and Treatment Patterns in Myasthenia Gravis: A 10-Year Real-World Data Analysis of German Claims Data

“…Our data also shows that the IR for females in early-onset MG is higher than that in male patients, whereas late-onset MG is more common in males. This bimodal distribution was observed in 5 of 14 studies by Carr et al [4] and in a Polish cohort [18]. The absolute gender ratio, however, showed a male predominance for incidence and prevalence.…”

Prevalence, Incidence, and Mortality of Myasthenia Gravis and Myasthenic Syndromes: A Systematic Review

“…For the ALL MG group, 59 studies [12‒70] estimated prevalence, and PRs ranged from 20 to 475 cases per million (online suppl. Table 3S), with a mean PR of 173.3 (95% CI: 129.7–215.5) cases per million and a median prevalence of 129.6 cases per million.…”

“…For the ALL MG group, 50 studies [12, 13, 16, 18‒21, 24‒30, 32, 35, 36, 38, 40, 41, 44, 48, 49, 52, 54, 57‒61, 63‒66, 68, 69, 81‒94] examined incidence. IRs ranged from 2.3 to 61.3 cases per million person-years (online suppl.…”

Myasthenia gravis—treatment and severity in nationwide cohort

“…As it was described elsewhere, 5 health care in Poland is delivered through a publicly funded healthcare system called the National Health Fund (Narodowy Fundusz Zdrowia, NFZ) established in 2004, which covers population of all employed citizens of Poland, their unemployed spouse, if applicable, registered unemployed, all minors, irrespective of employment status of the parents, and all retired citizens. We have used NFZ database to retrieve data of all prescriptions for pyridostigmine and ambenonium dispensed between January 1, 2012, and December 31, 2018.…”

“…We have used NFZ database to retrieve data of all prescriptions for pyridostigmine and ambenonium dispensed between January 1, 2012, and December 31, 2018. The same period was analyzed previously for epidemiological data 5 . Our inclusion criteria were as follows: at least one medical service coded in ICD‐10 as myasthenia gravis (G70) and at least two prescriptions for pyridostigmine or ambenonium in two consecutive years.…”

Incidence, Prevalence, Hospitalization Rates, and Treatment Patterns in Myasthenia Gravis: A 10-Year Real-World Data Analysis of German Claims Data

“…Our data also shows that the IR for females in early-onset MG is higher than that in male patients, whereas late-onset MG is more common in males. This bimodal distribution was observed in 5 of 14 studies by Carr et al [4] and in a Polish cohort [18]. The absolute gender ratio, however, showed a male predominance for incidence and prevalence.…”

Prevalence, Incidence, and Mortality of Myasthenia Gravis and Myasthenic Syndromes: A Systematic Review

“…For the ALL MG group, 59 studies [12‒70] estimated prevalence, and PRs ranged from 20 to 475 cases per million (online suppl. Table 3S), with a mean PR of 173.3 (95% CI: 129.7–215.5) cases per million and a median prevalence of 129.6 cases per million.…”

“…For the ALL MG group, 50 studies [12, 13, 16, 18‒21, 24‒30, 32, 35, 36, 38, 40, 41, 44, 48, 49, 52, 54, 57‒61, 63‒66, 68, 69, 81‒94] examined incidence. IRs ranged from 2.3 to 61.3 cases per million person-years (online suppl.…”

Myasthenia gravis—treatment and severity in nationwide cohort

“…As it was described elsewhere, 5 health care in Poland is delivered through a publicly funded healthcare system called the National Health Fund (Narodowy Fundusz Zdrowia, NFZ) established in 2004, which covers population of all employed citizens of Poland, their unemployed spouse, if applicable, registered unemployed, all minors, irrespective of employment status of the parents, and all retired citizens. We have used NFZ database to retrieve data of all prescriptions for pyridostigmine and ambenonium dispensed between January 1, 2012, and December 31, 2018.…”

“…We have used NFZ database to retrieve data of all prescriptions for pyridostigmine and ambenonium dispensed between January 1, 2012, and December 31, 2018. The same period was analyzed previously for epidemiological data 5 . Our inclusion criteria were as follows: at least one medical service coded in ICD‐10 as myasthenia gravis (G70) and at least two prescriptions for pyridostigmine or ambenonium in two consecutive years.…”

Incidence, Prevalence, Hospitalization Rates, and Treatment Patterns in Myasthenia Gravis: A 10-Year Real-World Data Analysis of German Claims Data

“…Our data also shows that the IR for females in early-onset MG is higher than that in male patients, whereas late-onset MG is more common in males. This bimodal distribution was observed in 5 of 14 studies by Carr et al [4] and in a Polish cohort [18]. The absolute gender ratio, however, showed a male predominance for incidence and prevalence.…”

Prevalence, Incidence, and Mortality of Myasthenia Gravis and Myasthenic Syndromes: A Systematic Review

“…For the ALL MG group, 59 studies [12‒70] estimated prevalence, and PRs ranged from 20 to 475 cases per million (online suppl. Table 3S), with a mean PR of 173.3 (95% CI: 129.7–215.5) cases per million and a median prevalence of 129.6 cases per million.…”

“…For the ALL MG group, 50 studies [12, 13, 16, 18‒21, 24‒30, 32, 35, 36, 38, 40, 41, 44, 48, 49, 52, 54, 57‒61, 63‒66, 68, 69, 81‒94] examined incidence. IRs ranged from 2.3 to 61.3 cases per million person-years (online suppl.…”

Myasthenia gravis—treatment and severity in nationwide cohort

“…As it was described elsewhere, 5 health care in Poland is delivered through a publicly funded healthcare system called the National Health Fund (Narodowy Fundusz Zdrowia, NFZ) established in 2004, which covers population of all employed citizens of Poland, their unemployed spouse, if applicable, registered unemployed, all minors, irrespective of employment status of the parents, and all retired citizens. We have used NFZ database to retrieve data of all prescriptions for pyridostigmine and ambenonium dispensed between January 1, 2012, and December 31, 2018.…”

“…We have used NFZ database to retrieve data of all prescriptions for pyridostigmine and ambenonium dispensed between January 1, 2012, and December 31, 2018. The same period was analyzed previously for epidemiological data 5 . Our inclusion criteria were as follows: at least one medical service coded in ICD‐10 as myasthenia gravis (G70) and at least two prescriptions for pyridostigmine or ambenonium in two consecutive years.…”