Patterns of Disease Monitoring and Treatment Among Patients with Tuberous Sclerosis Complex-related Angiomyolipomas

OBJECTIVE:

To use the tuberous sclerosis complex (TSC) Natural History Database to describe monitoring and treatment patterns among patients with TSC-related angiomyolipomas (AMLs).

METHODS:

This study used the TSC Natural History Database, which contains demographics, affected areas, diagnosis, and treatments for more than 1300 patients with TSC enrolled in 16 participating clinics during 2006-2013. Patient characteristics, AML monitoring tests, and AML treatments were assessed.

RESULTS:

Among the 621 patients with TSC-related AMLs, 54% were female; 77% were Caucasian. Median age at TSC diagnosis was <1 year whereas median age at aml diagnosis was 9.8 years. mostpatients84 had at least 1monitoringtest following aml diagnosis. the most commonly used tests were magnetic resonance imaging mri 65 ofpatients ultrasound 62 and computed tomography 41. between 2000 and 2012 mri made up an increasingly large proportion of the total number ofmonitoringtests. once diagnosed 155 25 ofpatientsreceivedtreatmentfor aml. the median time from diagnosis to firsttreatmentwas 3.8 years. the most common treatments were embolization 10 everolimus 9 sirolimus 6 and nephrectomy 6. the rate of nephrectomies declined over time with none conducted during 2011 and 2012. no subsequent surgeries were reported among the 71patientswho received mtor inhibitor as first-line therapy.>

CONCLUSION:

The use of MRIs increased between 2000 and 2012 among patients with TSC-AML. The majority of these patients did not receive treatment for AML. Use of nephrectomy decreased over the study period and was particularly rare in patients who received an mTOR inhibitor.