Z Gastroenterol 2018; 56(01): E2-E89
DOI: 10.1055/s-0037-1612705
Poster Visit Session II Clinical Hepatology – Friday, January 26, 2018, 2:35pm – 3:20pm, Room 120
Georg Thieme Verlag KG Stuttgart · New York

Prevalence and “real-life” treatment of autoimmune liver diseases in Germany

M Sebode
1   University Medical Center Hamburg-Eppendorf, I. Department of Medicine, Hamburg
,
A Kloppenburg
2   Wissenschaftliches Institut der Techniker Krankenkasse für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg
,
A Aigner
3   University Medical Center Hamburg-Eppendorf, Institute of Medical Biometry and Epidemiology, Hamburg
,
A Lohse
1   University Medical Center Hamburg-Eppendorf, I. Department of Medicine, Hamburg
,
R Linder
2   Wissenschaftliches Institut der Techniker Krankenkasse für Nutzen und Effizienz im Gesundheitswesen (WINEG), Hamburg
,
C Schramm
1   University Medical Center Hamburg-Eppendorf, I. Department of Medicine, Hamburg
› Author Affiliations
Further Information

Publication History

Publication Date:
03 January 2018 (online)

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Question:

The prevalence of autoimmune liver diseases (AILD) is unknown in Germany. We therefore aimed to determine the population-based prevalence of AILD and to assess “real-life” treatment regimes.

Methods:

We analysed the prevalence and treatment regimes of the AILD autoimmune hepatitis (AIH), primary biliary cholangitis (PBC) und primary sclerosing cholangitis (PSC) in Germany from 2011 to 2014 based on claims data of the health insurance company “Techniker Krankenkasse”. ICD10 codes of AILD in combination with prescription data were used to define cases. Data from around 8 million insured persons were analysed. The prevalence of AILD was compared to the prevalence of alcoholic liver cirrhosis and viral hepatitis B (acute and chronic). Prevalence rates of insured patients were adjusted to the sex and age distribution of the general German population.

Results:

The prevalence of AILD in Germany markedly increased over the four year time period. The prevalence of PBC increased by 30.9% (28 per 100,000 inhabitants in 2011 vs. 37 per 100,000 inhabitants in 2014) and the prevalence of AIH by 29.3% (18 per 100,000 inhabitants in 2011 vs. 23 per 100,000 inhabitants in 2014). The prevalence of PSC also increased (25 per 100,000 inhabitants in 2011 vs. 27 per 100,000 inhabitants in 2014), but to a lesser extent (10.3%). In contrast, the prevalence of the control liver diseases viral hepatitis B (829 per 100,000 inhabitants in 2012 and 632 per 100,000 inhabitants in 2014) and alcoholic liver cirrhosis (140 per 100,000 inhabitants in 2012 and 135 per 100,000 inhabitants in 2014) decreased or remained stable over time.

Population-based analysis of “real-life” treatment revealed deviations from current guidelines for AILD. UDCA is recommended as standard treatment for PBC. Interestingly, only 83% of patients with PBC were treated with UDCA in Germany from 2011 to 2014. In AIH, similar differences to guideline recommendations were found with 32% of patients also treated with UDCA and over 25% of patients receiving budesonide as corticosteroid.

Conclusions:

This population-based analysis suggests that the prevalence of AILD, especially of PBC and AIH, rose in Germany from 2011 to 2014 in contrast to control liver diseases. Analysis of “real-life” treatment revealed deviations from current guidelines for AILD.