Abstract Details

Title Incidence of Serious Infections among Patients with ALS in a U.S. Health Insurance Claims Database

Topic Anterior Horn

Presentation(s) P07 - (-)

Poster/Presentation
Number 086

Objective

Background BACKGROUND: Respiratory infections are common in ALS. Literature on other types of infections in patients with ALS is limited.

Design/Methods DESIGN/METHODS: Two cohorts of patients ? 18 years of age were included in this analysis: ALS patients (any patient with 1 inpatient or 2 outpatient medical claims containing ICD-9 code 335.20) and controls (n=65,000 randomly selected patients with no medical claims for ALS or other motor neuron diseases). Serious infections (bacteremia, cellulitis, encephalitis, endocarditis, meningitis, pneumonia, and pyelonephritis) were selected and defined using previously validated medical claims algorithms and inpatient claims. After excluding patients with previous history of an outcome within 60 days of the index date, each analysis included 65,000 controls and approximately 3260 ALS patients (min=3256, max=3265). Poisson regression was used to calculate incidence rates while Cox proportional hazards models were used to calculate hazard ratios (HR).

Results RESULTS: Age- and gender-adjusted incidence rates in ALS and controls, respectively (per 100,000 person-years): bacteremia 392.48 and 44.48; cellulitis 143.36 and 78.36; pneumonia 303.95 and 7.54; and pyelonephritis 68.41 and 15.07. Age- and gender-adjusted HRs in patients with ALS: bacteremia 8.7 (95% CI: 5.1, 14.8); cellulitis 1.8 (95% CI: 0.9, 3.4); pneumonia 39.8 (95% CI: 12.9, 123.2); and pyelonephritis 4.5 (95% CI: 1.0, 19.3). No cases of encephalitis, endocarditis, or meningitis were identified in ALS patients. Further results for other infections will be presented at conference.

Conclusions CONCLUSIONS: The present analysis found an increased risk of select serious infections requiring hospitalization among ALS patients relative to the general population. Clinicians should be vigilant for signs of infection in ALS patients.

Authors/Disclosures
James R. Williams III, PhD PRESENTER	Dr. Williams has received personal compensation for serving as an employee of Biogen. Dr. Williams has received stock or an ownership interest from Biogen.
Douglas A. Kerr, MD, PhD	Dr. Kerr has received personal compensation for serving as an employee of Dyne Therapeutics. Dr. Kerr has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for BlueRock Therapeutics. Dr. Kerr has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Trace Neuroscience. Dr. Kerr has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Spolia Therapeutics. Dr. Kerr has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for BlueRock Therapeutics. Dr. Kerr has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for AAVantgarde Therrapeutics. Dr. Kerr has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Trace Neuroscience. Dr. Kerr has or had stock in Dyne Therapeutics.
Wildon Farwell, MD	Dr. Farwell has received personal compensation for serving as an employee of Dyne Therapeutics. Dr. Farwell has received personal compensation for serving as an employee of Satellos Biosciences. Dr. Farwell has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Paragon Therapeutics. Dr. Farwell has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Stoke Therapeutics. Dr. Farwell has stock in Dyne Therapeutics. Dr. Farwell has stock in Satellos Bioscience.
Eric Swayze, PhD (Isis Pharmaceuticals)	No disclosure on file

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