C58-19 Geographic Co-Distribution of Sarcoidosis and Selected Comparators in the United States: A Cross-Sectional Analysis of United States Commercial Claims Data (2005-2023)

Rationale

Sarcoidosis is a chronic inflammatory disease with unknown etiology. Although environmental and immune-mediated mechanisms have been proposed connecting with Hodgkin’s lymphoma (HL) and idiopathic pulmonary fibrosis (IPF), respectively; no studies have evaluated whether sarcoidosis geographically co-localizes with these conditions across populations. We explored geographic associations between sarcoidosis, IPF, and HL in commercially insured population living in the United States from 2005 to 2023.

Methods

This ecological analysis was carried out using Merative™ MarketScan® Commercial Claims Database, with available information on residence defined as metropolitan statistical areas (MSAs). Cases were identified using International classification of diseases(ICD) codes and were defined as having ≥2 sarcoidosis claims (ICD-9-CM 135; ICD-10-CM D86.xx) or ≥ 1 claim for each comparator condition (IPF: ICD-9-CM 516.31; ICD-10-CM J84.112, J84.10; HD: ICD-9-CM 201.xx; ICD-10-CM C81.xx). Each condition was analyzed independently with individuals contributing once per condition based on the first qualifying diagnosis. MSAs with fewer than 20 cases and individuals with overlapping diagnoses were excluded to avoid double counting. Geographical clustering of prevalence for each condition was assessed using global Moran’s I. Association between conditions at the MSAs level were evaluated using Spearman rank correlation.

Results

We identified 195,022 sarcoidosis cases, 68,195 HL cases, and 14,308 IPF cases. The median prevalence across MSAs was 80.6 per 100,000 residents for sarcoidosis (interquartile range [IQR], 52.7-115.3), 29.3 for HL [IQR, 24.5-36.9] and 8.1 for IPF [IQR, 5.5-11.6]. Significant geographic clustering was observed for all three conditions to varying degrees: sarcoidosis (Moran’s I = 0.583; p < 0.0001), HD (Moran’s I = 0.472; p < 0.0001), and IPF (Moran’s I = 0.386; p < 0.0001). Sarcoidosis prevalence was moderately correlated with IPF (ρ = 0.487; p < 0.0001) and HL (ρ = 0.386; p < 0.0001) prevalence.

Conclusion

In this exploratory analysis, we found sarcoidosis has significant spatial co-localization with HL and IPF at the MSA level. These findings highlight a need to evaluate environmental factors contributing to the geographic patterns of these chronic inflammatory conditions.

This abstract is funded by: None