J Black1, N L Reaven2, S E Funk2, K McGaughey3, M M Ohayon4, C Guilleminault4, C Ruoff4. 1. Stanford University, Palo Alto, CA, USA; Jazz Pharmaceuticals, Palo Alto, CA, USA. Electronic address: jedblack@stanford.edu. 2. Strategic Health Resources, La Canada, CA, USA. 3. California Polytechnic State University, San Luis Obispo, CA, USA. 4. Stanford University, Palo Alto, CA, USA.
Abstract
OBJECTIVE/ BACKGROUND: The objective of this study was to evaluate medical comorbidity patterns in patients with a narcolepsy diagnosis in the United States. PATIENTS/ METHODS: This was a retrospective medical claims data analysis. Truven Health Analytics MarketScan® Research Databases were accessed to identify individuals ≥18 years of age with ≥1 diagnosis code for narcolepsy (International Classification of Diseases (ICD)-9, 347.0, 347.00, 347.01, 347.1, 347.10, or 347.11) continuously insured between 2006 and 2010, and controls without narcolepsy matched 5:1 on age, gender, region, and payer. Narcolepsy and control subjects were compared for frequency of comorbid conditions, identified by the appearance of >1 diagnosis code(s) mapped to a Clinical Classification System (CCS) level 1 category any time during the study period, and on specific subcategories, including recognized narcolepsy comorbidities of obstructive sleep apnea (OSA) and depression. RESULTS: The final study group included 9312 subjects with narcolepsy and 46,559 controls (each group: average age, 46.1 years; 59% female). As compared with controls, patients with narcolepsy showed a statistically significant excess prevalence in all the CCS multilevel categories, the only exceptions being conditions originating in the perinatal period and pregnancy/childbirth complications. The greatest excess prevalence in the narcolepsy cohort was seen for mental illness (31.1% excess prevalence; odds ratio (OR) 3.8, 95% confidence interval (CI) 3.6, 4.0), followed by diseases of the digestive system (21.4% excess prevalence; OR 2.7, 95% CI 2.5, 2.8) and nervous system/sense organs (excluding narcolepsy; 20.7% excess prevalence; OR 3.7, 95% CI 3.4, 3.9). CONCLUSIONS: In this claims analysis, a narcolepsy diagnosis was associated with a wide range of comorbid medical illness claims, at significantly higher rates than matched controls.
OBJECTIVE/ BACKGROUND: The objective of this study was to evaluate medical comorbidity patterns in patients with a narcolepsy diagnosis in the United States. PATIENTS/ METHODS: This was a retrospective medical claims data analysis. Truven Health Analytics MarketScan® Research Databases were accessed to identify individuals ≥18 years of age with ≥1 diagnosis code for narcolepsy (International Classification of Diseases (ICD)-9, 347.0, 347.00, 347.01, 347.1, 347.10, or 347.11) continuously insured between 2006 and 2010, and controls without narcolepsy matched 5:1 on age, gender, region, and payer. Narcolepsy and control subjects were compared for frequency of comorbid conditions, identified by the appearance of >1 diagnosis code(s) mapped to a Clinical Classification System (CCS) level 1 category any time during the study period, and on specific subcategories, including recognized narcolepsy comorbidities of obstructive sleep apnea (OSA) and depression. RESULTS: The final study group included 9312 subjects with narcolepsy and 46,559 controls (each group: average age, 46.1 years; 59% female). As compared with controls, patients with narcolepsy showed a statistically significant excess prevalence in all the CCS multilevel categories, the only exceptions being conditions originating in the perinatal period and pregnancy/childbirth complications. The greatest excess prevalence in the narcolepsy cohort was seen for mental illness (31.1% excess prevalence; odds ratio (OR) 3.8, 95% confidence interval (CI) 3.6, 4.0), followed by diseases of the digestive system (21.4% excess prevalence; OR 2.7, 95% CI 2.5, 2.8) and nervous system/sense organs (excluding narcolepsy; 20.7% excess prevalence; OR 3.7, 95% CI 3.4, 3.9). CONCLUSIONS: In this claims analysis, a narcolepsy diagnosis was associated with a wide range of comorbid medical illness claims, at significantly higher rates than matched controls.
Authors: Michel Lecendreux; Giuseppe Plazzi; Yves Dauvilliers; Carol L Rosen; Chad Ruoff; Jed Black; Rupa Parvataneni; Diane Guinta; Y Grace Wang; Emmanuel Mignot Journal: J Clin Sleep Med Date: 2022-09-01 Impact factor: 4.324