Treatment patterns for eosinophilic granulomatosis with polyangiitis (EGPA): a retrospective observational cohort study in England

<bold>Background:</bold> Oral glucocorticoids (OGC) remain the primary drug therapy recommended for EGPA; immunosuppressants and/or biologics may be added to maintain remission and reduce OGC toxicity. <bold>Aim:</bold> To assess treatment patterns for EGPA in a real-world setting. <bold>Methods:</bold> The study period was 01 Jan 2006–28 Feb 2019. Primary care data from Clinical Practice Research Datalink Aurum were linked to outpatient morbidity data from Hospital Episode Statistics; patients with an EGPA diagnosis during the study period and ≥1 year of data before diagnosis (index date [ID]) were identified. We assessed EGPA prognosis (five factor score [FFS] 2009 version at ID) and treatments prescribed at any time after ID; follow-up was from ID to death, deregistration, last GP data collection or study end. <bold>Results:</bold> Patients (N=486) had a mean age of 57.9 years; 50.2% were female; 29.2% had an FFS of 2, indicating severe disease (FFS 1, 44.7%; FFS 0, 26.1%). Mean (SD) follow-up after ID was 5.4 (3.7) years. During the study period, >86% were prescribed OGCs; 54% were prescribed immunosuppressants, and 2.7% biologics (1.6% mepolizumab, 1% rituximab; Figure). <bold>Conclusion:</bold> OGCs and immunosuppressants remain the most common EGPA therapies in the UK. Greater access to eosinophil-directed biologics and novel immune-targeted therapies may further limit exposure to OGCs. Figure. Drug therapies prescribed at any time after ID^a <fig><object-id>erj;64/suppl_68/PA730/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>