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Higher prevalence of non-skeletal comorbidity related to X-linked hypophosphataemia: a UK CPRD parallel cohort study

Higher prevalence of non-skeletal comorbidity related to X-linked hypophosphataemia: a UK CPRD parallel cohort study
Higher prevalence of non-skeletal comorbidity related to X-linked hypophosphataemia: a UK CPRD parallel cohort study
Objectives
X-Linked hypophosphataemic rickets (XLH) is a rare multisystemic disease of mineral homeostasis that has a prominent skeletal phenotype. The aim of this study was to describe additional comorbidities in XLH patients compared with general population controls.

Methods
The Clinical Practice Research Datalink (CPRD) GOLD was used to identify a cohort of XLH patients (1995–2016), along with a non-XLH cohort matched (1:4) on age, sex and GP practice. Using the CALIBER portal, phenotyping algorithms were used to identify the first diagnosis (and associated age) of 273 comorbid conditions during patient follow-up. Fifteen major disease categories were used and the proportion of patients having ≥1 diagnosis was compared between cohorts for each category and condition. Main analyses were repeated according to Index of Multiple Deprivation (IMD).

Results
There were 64 and 256 patients in the XLH and non-XLH cohorts, respectively. There was increased prevalence of endocrine (OR 3.46 [95% CI: 1.44–8.31]) and neurological (OR 3.01 [95% CI: 1.41–6.44] disorders among XLH patients. Across all specific comorbidities, four were at least twice as likely to be present in XLH cases, but only depression met the Bonferroni threshold: OR 2.95 [95%CI: 1.47–5.92]. Distribution of IMD among XLH cases indicated greater deprivation than the general population.

Conclusion
We describe a higher risk of mental illness in XLH patients compared with matched controls, and greater than expected deprivation. These findings may have implications for clinical practice guidelines and decisions around health and social care provision for these patients.
1462-0324
Hawley, Samuel
407712ed-30ba-4458-a0f3-f6278e219845
Shaw, Nick J.
c9b53ab7-ca2d-4744-83ad-ffe9c1f6a094
Delmestri, Antonella
c1dfbd4f-1ec0-4e02-a6fa-423f90edc322
Prieto-Alhambra, Daniel
e596722a-2f01-4201-bd9d-be3e180e76a9
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Pinedo-Villanueva, Rafael
d038070d-b785-4ec9-9b27-4724561fd6ef
Kassim Javaid, M.
12781b29-34fa-4158-837b-daf452b8d4ed
Hawley, Samuel
407712ed-30ba-4458-a0f3-f6278e219845
Shaw, Nick J.
c9b53ab7-ca2d-4744-83ad-ffe9c1f6a094
Delmestri, Antonella
c1dfbd4f-1ec0-4e02-a6fa-423f90edc322
Prieto-Alhambra, Daniel
e596722a-2f01-4201-bd9d-be3e180e76a9
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Pinedo-Villanueva, Rafael
d038070d-b785-4ec9-9b27-4724561fd6ef
Kassim Javaid, M.
12781b29-34fa-4158-837b-daf452b8d4ed

Hawley, Samuel, Shaw, Nick J., Delmestri, Antonella, Prieto-Alhambra, Daniel, Cooper, Cyrus, Pinedo-Villanueva, Rafael and Kassim Javaid, M. (2020) Higher prevalence of non-skeletal comorbidity related to X-linked hypophosphataemia: a UK CPRD parallel cohort study. Rheumatology. (doi:10.1093/rheumatology/keaa859).

Record type: Article

Abstract

Objectives
X-Linked hypophosphataemic rickets (XLH) is a rare multisystemic disease of mineral homeostasis that has a prominent skeletal phenotype. The aim of this study was to describe additional comorbidities in XLH patients compared with general population controls.

Methods
The Clinical Practice Research Datalink (CPRD) GOLD was used to identify a cohort of XLH patients (1995–2016), along with a non-XLH cohort matched (1:4) on age, sex and GP practice. Using the CALIBER portal, phenotyping algorithms were used to identify the first diagnosis (and associated age) of 273 comorbid conditions during patient follow-up. Fifteen major disease categories were used and the proportion of patients having ≥1 diagnosis was compared between cohorts for each category and condition. Main analyses were repeated according to Index of Multiple Deprivation (IMD).

Results
There were 64 and 256 patients in the XLH and non-XLH cohorts, respectively. There was increased prevalence of endocrine (OR 3.46 [95% CI: 1.44–8.31]) and neurological (OR 3.01 [95% CI: 1.41–6.44] disorders among XLH patients. Across all specific comorbidities, four were at least twice as likely to be present in XLH cases, but only depression met the Bonferroni threshold: OR 2.95 [95%CI: 1.47–5.92]. Distribution of IMD among XLH cases indicated greater deprivation than the general population.

Conclusion
We describe a higher risk of mental illness in XLH patients compared with matched controls, and greater than expected deprivation. These findings may have implications for clinical practice guidelines and decisions around health and social care provision for these patients.

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Restricted to Repository staff only until 17 December 2021.
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More information

Accepted/In Press date: 12 November 2020
e-pub ahead of print date: 17 December 2020

Identifiers

Local EPrints ID: 446261
URI: http://eprints.soton.ac.uk/id/eprint/446261
ISSN: 1462-0324
PURE UUID: aa68c085-339e-4996-ae32-68b0cc77cade
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 02 Feb 2021 17:30
Last modified: 18 Feb 2021 16:48

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Contributors

Author: Samuel Hawley
Author: Nick J. Shaw
Author: Antonella Delmestri
Author: Daniel Prieto-Alhambra
Author: Cyrus Cooper ORCID iD
Author: Rafael Pinedo-Villanueva
Author: M. Kassim Javaid

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