Abstract Rationale Characterizing patient subgroups in eosinophilic granulomatosis with polyangiitis (EGPA) is critical for understanding disease heterogeneity; however, evidence to date remains limited. This real-world analysis contributes to addressing this gap by describing the disease burden and clinical characteristics across defined EGPA subgroups. Methods This secondary analysis utilized data from the Adelphi Real World EGPA Disease Specific Program™, a cross-sectional survey linking physician- and patient-reported information with retrospective data collection, conducted in France, Germany, Italy, Spain, the UK, and USA between August 2023 and February 2024. The study population comprised patients aged ≥10 years with a physician-confirmed diagnosis of EGPA. Demographics, clinical characteristics, healthcare resource utilization, treatment patterns, and symptom scores (during survey or retrospectively) were analyzed across EGPA subgroups based on physician-perceived EGPA severity, biologic use, anti-neutrophil cytoplasmic antibodies (ANCA) status and recent peak blood eosinophil count (BEC). Results Among 458 eligible patients, 37% were ANCA-positive (55% unknown), 8% had recent BEC ≥1000 cells/µl (39% unknown), 4% had physician-perceived severe EGPA, and 55% were current/previous biologic users (Table). The proportion of patients of White ethnicity was lower among patterns with perceived severe EGPA (56% compared with 74% overall). Mean (SD) days since initial EGPA diagnosis ranged from 691.1 (962.1) to 1692.6 (1507.9) and was shorter in recent high BEC, perceived severe EGPA, and no biologic use subgroups. Most patients (73%) experienced organ damage, with the highest burden (80%) observed in patients with recent BEC 300-499 cells/µl and in biologic users. Mean (SD) Birmingham vasculitis activity scores ranged from 6.8 (7.7) in the subgroup without biologics to 24.5 (0.7) in patients with perceived severe EGPA. Perceived severe EGPA and biologic use subgroups reported a higher proportion of patients with BEC ≥1000 cells/µl both at EGPA diagnosis and at survey time (Table). Emergency room visits and hospitalizations in the past 12 months were reported by 17% and 15% of patients, with high burden noted among perceived severe EGPA biologic use, ANCA-positive, and higher BEC subgroups. Corticosteroid use remained common across all subgroups and varied from 69% (biologic users) to 94% (≥1000 cells/µl subgroup). Conclusions Patients with EGPA have substantial unmet needs and heterogeneous clinical profiles that may reflect differences across disease stages, treatments, clinical practice, and access to care. Reported subgroup differences should be interpreted cautiously given missing ANCA data and inherent limitations of real-world data such as non-random sampling and variability in physician-perceived disease severity. This abstract is funded by: GSK (219789)
Le et al. (Fri,) studied this question.