# Burden of eosinophilic granulomatosis with polyangiitis by disease phase and steroid-sparing effects of biologics: a real-world retrospective study in Europe

## TL;DR

This study examines the real-world disease burden of EGPA across Europe and finds that biologics may reduce steroid use and improve disease control.

## Contribution

The study provides real-world evidence on EGPA disease phases and the steroid-sparing effects of biologics in European patients.

## Key findings

- The vasculitic phase of EGPA is associated with the highest comorbidity and healthcare resource use.
- Biologics are linked to reduced oral corticosteroid use and increased remission rates.
- All EGPA subgroups show a high disease burden despite varying severity.

## Abstract

The aim of the study was to describe insights into real-world characteristics and clinical outcomes of patients with a history of eosinophilic granulomatosis with polyangiitis (EGPA) across Europe, stratified by disease phase and biologics use.

This was a retrospective, physician-panel chart review study in patients with a history of EGPA from five European countries covering the period January 2015–August 2021 (GSK ID: 214661). Outcomes assessed included: baseline characteristics; treatment patterns; clinical outcomes and healthcare resource utilisation (HCRU), which were stratified post hoc by EGPA disease phase and biologics use. Oral corticosteroid (OCS) use was assessed ≤12 months pre- and post-biologics initiation.

Overall, 407 patients were included: disease phase was identified for 381 patients (36 prodromal; 220 eosinophilic; 125 vasculitic); 185 patients received biologics, and 162 had pre-/post-biologics initiation periods identified. Patients in the vasculitic subgroup had the most comorbidities and clinical manifestations, and the greatest proportion of patients with hospitalisation versus the eosinophilic or prodromal subgroups. All subgroups had high OCS use (97.2–99.1%). The biologics-exposed subgroup had high comorbidity and HCRU burden. Post- versus pre-biologics initiation, OCS use was reduced (0.12 versus 0.69 prescriptions per person-year), the proportion of patients experiencing relapses decreased (3.1% (95% confidence interval: 0.4–5.7) versus 11.7% (6.8–16.7)) and remissions increased (26.5% (19.7–33.3) versus 13.0% (7.8–18.1).

Although the vasculitic subgroup showed the greatest disease severity, all subgroups demonstrated a substantial disease burden. Results also suggest biologics provide OCS-sparing effects and improve disease control in real-world settings.

All eosinophilic granulomatosis with polyangiitis (EGPA) disease phase subgroups have substantial disease burden; the vasculitic subgroup has more severe disease. Biologics may reduce corticosteroid use and improve EGPA control in a real-world setting.
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