REAL-WORLD TREATMENT PATTERNS AND CLINICAL OUTCOMES OF PATIENTS WITH PRIMARY AUTOIMMUNE HEMOLYTIC ANEMIA IN BRAZIL: A CLAIMS DATABASE STUDY

@article{oliveira2026realworld,
  title = {{REAL-WORLD TREATMENT PATTERNS AND CLINICAL OUTCOMES OF PATIENTS WITH PRIMARY AUTOIMMUNE HEMOLYTIC ANEMIA IN BRAZIL: A CLAIMS DATABASE STUDY}},
  author = {Renato Watanabe DE OLIVEIRA and Ligia Taveira Engler Raiz COELHO and Gabriela Ana KANEVSKY and Thaís Zamboni BERRA and Gustavo Matheus PIRES and Renato Sampaio TAVARES},
  journal = {Hematology, Transfusion and Cell Therapy},
  year = {2026},
  month = oct,
  doi = {10.1016/j.htct.2026.106700},
  url = {https://doi.org/10.1016/j.htct.2026.106700},
  note = {CC BY},
}

TY  - JOUR
TI  - REAL-WORLD TREATMENT PATTERNS AND CLINICAL OUTCOMES OF PATIENTS WITH PRIMARY AUTOIMMUNE HEMOLYTIC ANEMIA IN BRAZIL: A CLAIMS DATABASE STUDY
AU  - Renato Watanabe DE OLIVEIRA
AU  - Ligia Taveira Engler Raiz COELHO
AU  - Gabriela Ana KANEVSKY
AU  - Thaís Zamboni BERRA
AU  - Gustavo Matheus PIRES
AU  - Renato Sampaio TAVARES
PY  - 2026
DA  - 2026/10/23
JO  - Hematology, Transfusion and Cell Therapy
DO  - 10.1016/j.htct.2026.106700
UR  - https://doi.org/10.1016/j.htct.2026.106700
AB  - Introduction: Autoimmune hemolytic anemia (AIHA) is a rare disorder marked by immune-driven red blood cell destruction, in which a group of patients experience severe, potentially fatal disease requiring transfusions or intensive care. In Brazil, the scarcity of real-world evidence on AIHA management hampers informed clinical and policy decision-making. Objective: To describe the treatment profile of patients with primary AIHA submitted to second or subsequent-line treatment in the Brazilian public healthcare system, between 2013 and 2023. Material and Methods: This retrospective observational study used claims data from DATASUS, which represents 75% of Brazilian population. We included adult patients (≥18-years-old), with their first AIHA claim (ICD-10: D59.1; at least one inpatient or two outpatient claims) between 2013 and 2023, and with ≥12-months of follow-up. Patients with secondary or drug-induced AIHA (ICD-10 D59.0) were excluded. Treatments assessed included immunosuppressants, splenectomy or rescue therapies (IVIg, blood transfusion or plasmapheresis); corticosteroids are not available in the database. Demographics, treatment and hospitalizations were described using descriptive statistics, with rates calculated by number of events per patient-year (PPY). Results: A total of 2,893 patients with primary AIHA were identified. Patients had a mean age of 47.8±19.2 years, were predominantly female (67.2%), and were mainly concentrated in the states of São Paulo (24.9%), Rio Grande do Sul (8.9%) and Minas Gerais (7.5%). Multimorbidity was frequent (mean 2.6 comorbidities), most commonly idiopathic thrombocytopenic purpura (2.1%) and septicemia (1.9%). A total of 1355 (46.8%) patients received systemic therapy; of them, 8.0% used immunosuppressants (cyclosporine: 69.7%; cyclophosphamide: 33.0%). Splenectomy was performed in 14.4% of total patients, 99.5% of them prior to immunosuppressant therapy. Of the total patients, 43.5%% required at least one rescue treatment in the period; of them, mainly blood transfusion (79.8%, mean use 1.2) and IVIg (20.8%; mean 4.3 administrations), with a rescue therapy rate of 2.3 (95% CI 2.0–2.6) uses PPY. Around 84% of all patients required at least one hospitalization in the period (median stay 7 days), corresponding to a hospitalization rate of 3 (95% CI 2.6–3.3) events PPY. Of all hospitalizations, 10.3% of them required ICU admission (median 10-days). Conclusion: Primary AIHA is associated with substantial clinical burden and intensive healthcare utilization, reflected in high dependence on rescue therapies and frequent hospitalizations. Our results suggest the need for new therapeutic strategies and treatment options for long-term disease control.
SN  - 2531-1379
SN  - 2531-1387
ER  -