Burden of disease associated with a COPD eosinophilic phenotype

Figures & data

Table 1 Demographic characteristics and comorbidities in the MT population, 2012–2015

MT population	Year
	2012	2013	2014	2015
	N=2,802	N=2,822	N=2,847	N=2,858
Age at index date (years),a mean ± SD	70.0±11.8	69.9±11.7	70.1±11.5	70.3±11.4
Male,a n (%)	1,184 (42.3)	1,202 (42.6)	1,222 (42.9)	1,204 (42.1)
Insurance type,a n (%)
Commercial	252 (9.0)	255 (9.0)	304 (10.7)	305 (10.7)
Medicare	1,173 (41.9)	1,164 (41.2)	1,090 (38.3)	1,167 (40.8)
Medicaid	74 (2.6)	67 (2.4)	45 (1.6)	117 (4.1)
Unknown	1,303 (46.5)	1,336 (47.3)	1,408 (49.5)	1,269 (44.4)
Body mass indexa
Number of patients, n (%)	2,653 (94.7)	2,651 (93.9)	2,661 (93.5)	2,748 (96.2)
Mean ± SD (median)	29.3±7.4 (28)	29.4±7.4 (28)	29.3±7.4 (28)	29.2±7.4 (28)
Quan-Charlson comorbidity index,b mean ± SD	2.5±2.9	2.4±3.0	2.1±2.9	2.9±3.0
Comorbidities,b n (%)
Cardiovascular disease	2,114 (75.4)	2,142 (75.9)	2,120 (74.5)	2,239 (78.3)
Diabetes	891 (31.8)	873 (30.9)	812 (28.5)	843 (29.5)
Asthma	690 (24.6)	667 (23.6)	635 (22.3)	583 (20.4)
Respiratory infections	503 (18.0)	478 (16.9)	470 (16.5)	517 (18.1)
Allergic rhinitis	316 (11.3)	323 (11.4)	343 (12.0)	345 (12.1)
Chronic sinusitis	197 (7.0)	181 (6.4)	209 (7.3)	176 (6.2)
Acute sinusitis	120 (4.3)	77 (2.7)	82 (2.9)	129 (4.5)
Rheumatoid arthritis	52 (1.9)	56 (2.0)	53 (1.9)	64 (2.2)
Blood eosinophil measurec
Number of patients, n (%)	773 (27.6)	768 (27.2)	788 (27.7)	803 (28.1)
Number of measures, mean ± SD (median)	4.3±5.6 (2)	4.6±6.4 (2)	4.5±6.1 (2)	4.7±6.6 (2)
Eosinophil cells/µL, mean ± SD (median)	288.9±268.0 (226)	289.3±243.9 (221)	309.2±284.4 (231)	302.7±259.2 (238)
≥150 cells/µL, n (%)	548 (70.9)	562 (73.2)	575 (73.0)	592 (73.7)
≥300 cells/µL, n (%)	298 (38.6)	282 (36.7)	326 (41.4)	321 (40.0)
≥400 cells/µL, n (%)	184 (23.8)	189 (24.6)	203 (25.8)	196 (24.4)

Notes:

a Evaluated at the closest value from July 1 of the year of interest.

b Assessed within the calendar year of interest.

c Evaluated as the highest eosinophil count value during the calendar year of interest.

Abbreviation: MT, maintenance therapy.

Figure 1 Proportions of patients in subgroups of clinical interest* for the calendar years 2012 (A), 2013 (B), 2014 (C), and 2015 (D).

Notes: (A) 2012; MT population N=2,802. (B) 2013; MT population N=2,822. (C) 2014; MT population N=2,847. (D) 2015; MT population N=2,858. *Discrepancies between the sum of patients in the 3 subgroups of clinical interest and the MT population each year are accounted for by patients in the MT population who did not meet the criteria for any subgroup of clinical interest.
Abbreviation: MT, maintenance therapy.

Table 2 Annual all-cause health care resource utilization by blood eosinophil count cohort (2012–2015)

All-cause health care resource utilization, mean ± SD	2012 patients with blood eosinophil count (N=773)		2013 patients with blood eosinophil count (N=768)		2014 patients with blood eosinophil count (N=788)		2015 patients with blood eosinophil count (N=803)
	Eosinophil count <150 cells/µL (n=225)	Eosinophil count ≥150 cells/µL (n=548)	Eosinophil count <150 cells/µL (n=206)	Eosinophil count ≥150 cells/µL (n=562)	Eosinophil count <150 cells/µL (n=213)	Eosinophil count ≥150 cells/µL (n=575)	Eosinophil count <150 cells/µL (n=211)	Eosinophil count ≥150 cells/µL (n=592)
Hospitalizations	0.5±1.2a	0.8±1.7a	0.4±1.5	0.6±1.3	0.3±1.0a	0.4±1.1a	0.6±1.6	0.6±1.3
ER visits	0.5±1.3	0.6±1.2	0.4±1.5a	0.7±2.0a	0.4±1.2	0.5±1.2	0.8±1.7	1.0±3.0
Outpatient visits	16.9±16.9a	20.1±17.2a	17.5±17.8	18.3±17.9	12.7±15.0a	15.6±18.0a	16.0±14.5b	20.1±18.5b
Other visits	11.7±15.1c	17.9±23.3c	15.1±24.2	18.5±30.2	9.1±16.2a	12.0±19.7a	14.0±23.9	15.7±20.8

Note: Statistical significance is indicated as

a P≤0.05,

b P≤0.01,

c P≤0.001.

Abbreviation: ER, emergency room.

Figure 2 COPD-related health care resource utilization by blood eosinophil count cohort for years 2012–2015.

Notes: Statistically significant differences between cohorts are indicated as *P≤0.01, **P≤0.001. Error bars show standard error.
Abbreviation: ER, emergency room.

Figure 3 Multivariate analysis of COPD-related and all-cause annual medical costs for patients with blood eosinophil counts <150 cells/µL and ≥150 cells/µL, either with exacerbations (A) or without exacerbations (B).

Notes: Numbers show adjusted* cost differences, 95% CIs, and adjusted P-values. *Adjusting for age, gender, insurance type, BMI, blood pressure, calendar year, asthma, malignant neoplasm of respiratory and intrathoracic system, rheumatoid arthritis, Crohn’s disease, systemic lupus erythematosus, multiple sclerosis, allergic rhinitis, respiratory infections, chronic sinusitis, diabetes, cardiovascular disease, acute sinusitis, atopic dermatitis, eosinophilic granulomatosis with polyangiitis, nasal polyps, hypereosinophilic syndrome, eosinophilic esophagitis, bacterial infections, CCI score, and triple therapy use.
Abbreviations: BMI, body mass index; CCI, Quan-Charlson comorbidity index.

Figure 4 Multivariate analysis of COPD-related and all-cause annual medical costs for patients with and without exacerbations, with either blood eosinophil count <150 cells/µL (A) or ≥150 cells/µL (B).

Notes: Numbers show adjusted* cost differences, 95% CIs, and adjusted P-values. *Adjusting for age, gender, insurance type, BMI, blood pressure, calendar year, asthma, malignant neoplasm of respiratory and intrathoracic system, rheumatoid arthritis, Crohn’s disease, systemic lupus erythematosus, multiple sclerosis, allergic rhinitis, respiratory infections, chronic sinusitis, diabetes, cardiovascular disease, acute sinusitis, atopic dermatitis, eosinophilic granulomatosis with polyangiitis, nasal polyps, hypereosinophilic syndrome, eosinophilic esophagitis, bacterial infections, CCI score, and triple therapy use.
Abbreviations: BMI, body mass index; CCI, Quan-Charlson comorbidity index.