Incidence of Cushing's Disease in the United States

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 88-111-Cushing's Disease & Non-Functioning Hypothalamus-Pituitary Tumors
Clinical
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-91
Michael S Broder1, Maureen P. Neary*2, Eunice Chang1, William Henry Ludlam2 and Dasha Cherepanov1
1Partnership for Health Analytic Research, Beverly Hills, CA, 2Novartis Pharmaceuticals Corporation, East Hanover, NJ
OBJECTIVES: Cushing’s disease (CD) is a rare disorder caused by excess adrenocorticotropic hormone secretion by a pituitary tumor. Although consistent epidemiologic data are lacking, one study reported the incidence of CD at 2.4 per million population per year. We estimated the incidence of CD using a large database of commercially-insured patients in the US.

METHODS:  Data from 2007 to 2010 in MarketScan Commercial database (age <65 years) were used in this study. For 2009 and 2010, CD patients were defined as those who had a claim with Cushing’s syndrome diagnosis and either benign pituitary adenomas diagnosis or hypophysectomy in the same calendar year. Patients were required to have 1-year continuous enrollment to be included. In addition, patients were continuously-enrolled and were disease-free in the prior 2 years. Estimates of incidence were calculated by dividing the number of CD cases by the total number of members with same enrollment requirement during the calendar years. We conducted a sensitivity analysis that required a 1 year prior enrollment and disease-free period for incidence estimation.

RESULTS: Two-year disease-free CD incidence rates per million person year (PMPY) were 7.6 in 2009 and 6.2 in 2010. The rates varied by age with lowest rates of 2.4 to 2.8 (per year) in ≤17 year olds and highest rates of 9.4 to 17.7 (per year) in 18-24 year olds. The rates also varied by sex from 2.3 to 2.7 (per year) in males and from 9.8 to 12.1 (per year) in females. In females, the lowest incidence rates ranged from 2.5 to 4.0 (per year) in ≤17 year olds and the highest from 16.7 to 27.2 (per year) in 18-24 year olds. In males, there were too few incident cases to report age-specific incidence rate estimates. Sensitivity analysis resulted in similar incidence estimates of 7.9 in 2009 and 6.3 PMPY in 2010. In this cohort, the incidence was also lowest in the ≤17 year olds (ranging 2.0 to 2.1 PMPY) and highest in 18-24 year olds (10.0 to 13.7 PMPY), and also lower in males (2.0 to 3.4 PMPY) than in females (12.0 to 10.2 PMPY).

CONCLUSIONS:  Our study indicates that the annual incidence of CD in US individuals <65 years old may be up to 8 cases per million, or approximately 2,000  new cases per year in the US, and may be higher in certain subgroups. The incidence of CD is greatest among females and those >18 years old.

Disclosure: MSB: Researcher, Novartis Pharmaceuticals. MPN: Employee, Novartis Pharmaceuticals. EC: Researcher, Novartis Pharmaceuticals. WHL: Employee, Novartis Pharmaceuticals. DC: Researcher, Novartis Pharmaceuticals.

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

Sources of Research Support: Funding for this study was provided by Novartis Pharmaceuticals Corporation.