Real-World Burden of Immunosuppressant-Treated Lupus Nephritis: A German Claims Database Analysis
Abstract Introduction This retrospective cohort study (GSK213737) aimed to characterize treatment patterns, healthcare resource utilization (HCRU), and costs in patients with lupus nephritis (LN) initiating immunosuppressant therapy in clinical practice in Germany, to better understand the full pict...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Adis, Springer Healthcare
2023-11-01
|
| Series: | Rheumatology and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s40744-023-00623-4 |
| _version_ | 1797349714696339456 |
|---|---|
| author | Elena Garal-Pantaler Michael Schultze Mary Elizabeth Georgiou Marc Pignot Kerry Gairy Jacob N. Hunnicutt |
| author_facet | Elena Garal-Pantaler Michael Schultze Mary Elizabeth Georgiou Marc Pignot Kerry Gairy Jacob N. Hunnicutt |
| author_sort | Elena Garal-Pantaler |
| collection | DOAJ |
| description | Abstract Introduction This retrospective cohort study (GSK213737) aimed to characterize treatment patterns, healthcare resource utilization (HCRU), and costs in patients with lupus nephritis (LN) initiating immunosuppressant therapy in clinical practice in Germany, to better understand the full picture of the real-world burden of LN. Methods Adult patients with LN who initiated mycophenolate mofetil (MMF), intravenous cyclophosphamide (CYC), azathioprine (AZA), tacrolimus, cyclosporin A, or rituximab therapy in 2011–2017 (index therapy) were identified from the Betriebskrankenkassen German Sickness Fund database. Treatment patterns, including immunosuppressant discontinuations, and therapy switches, were assessed (maximum follow-up 4 years). Corticosteroid use, HCRU, and total economic costs were also evaluated. HCRU and costs were compared with matched controls (individuals without systemic lupus erythematosus [SLE]/LN matched by age, sex, and baseline Charlson Comorbidity Index). Results Among 334 patients with LN, the median (interquartile range) duration of index immunosuppressant therapy use was 380.5 (126, 1064) days. Of those patients with 4 years complete enrollment, 70.8% had ≥ 1 discontinuation and 28.8% switched therapy. While most patients (71.2%) received only one immunosuppressant, gaps in treatment were common. After 1 year of follow-up, 41.6% of patients had a prednisone-equivalent corticosteroid dose of ≥ 7.5 mg/day. Patients with LN had greater HCRU use for most categories assessed and increased mean total costs per person-year versus controls (€15,115.99 versus €4,081.88 in the first year of follow-up). Conclusions This real-world analysis demonstrated the considerable burden of immunosuppressant-treated LN in Germany, with a high rate of discontinuations, frequent use of high-dose corticosteroids, and substantial HCRU/costs. |
| first_indexed | 2024-03-08T12:34:22Z |
| format | Article |
| id | doaj.art-5bf7dc5b585f4f20bfcd5f3b2d555e15 |
| institution | Directory Open Access Journal |
| issn | 2198-6576 2198-6584 |
| language | English |
| last_indexed | 2024-03-08T12:34:22Z |
| publishDate | 2023-11-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Rheumatology and Therapy |
| spelling | doaj.art-5bf7dc5b585f4f20bfcd5f3b2d555e152024-01-21T12:34:55ZengAdis, Springer HealthcareRheumatology and Therapy2198-65762198-65842023-11-0111111312710.1007/s40744-023-00623-4Real-World Burden of Immunosuppressant-Treated Lupus Nephritis: A German Claims Database AnalysisElena Garal-Pantaler0Michael Schultze1Mary Elizabeth Georgiou2Marc Pignot3Kerry Gairy4Jacob N. Hunnicutt5Health Care Research and Health Economics (Versorgungsforschung und Gesundheitsökonomie), Team Gesundheit GmbHBerlin Center for Epidemiology and Health Research, ZEG Berlin GmbHValue Evidence and Outcomes, GSKBerlin Center for Epidemiology and Health Research, ZEG Berlin GmbHValue Evidence and Outcomes, GSKValue Evidence and Outcomes, GSKAbstract Introduction This retrospective cohort study (GSK213737) aimed to characterize treatment patterns, healthcare resource utilization (HCRU), and costs in patients with lupus nephritis (LN) initiating immunosuppressant therapy in clinical practice in Germany, to better understand the full picture of the real-world burden of LN. Methods Adult patients with LN who initiated mycophenolate mofetil (MMF), intravenous cyclophosphamide (CYC), azathioprine (AZA), tacrolimus, cyclosporin A, or rituximab therapy in 2011–2017 (index therapy) were identified from the Betriebskrankenkassen German Sickness Fund database. Treatment patterns, including immunosuppressant discontinuations, and therapy switches, were assessed (maximum follow-up 4 years). Corticosteroid use, HCRU, and total economic costs were also evaluated. HCRU and costs were compared with matched controls (individuals without systemic lupus erythematosus [SLE]/LN matched by age, sex, and baseline Charlson Comorbidity Index). Results Among 334 patients with LN, the median (interquartile range) duration of index immunosuppressant therapy use was 380.5 (126, 1064) days. Of those patients with 4 years complete enrollment, 70.8% had ≥ 1 discontinuation and 28.8% switched therapy. While most patients (71.2%) received only one immunosuppressant, gaps in treatment were common. After 1 year of follow-up, 41.6% of patients had a prednisone-equivalent corticosteroid dose of ≥ 7.5 mg/day. Patients with LN had greater HCRU use for most categories assessed and increased mean total costs per person-year versus controls (€15,115.99 versus €4,081.88 in the first year of follow-up). Conclusions This real-world analysis demonstrated the considerable burden of immunosuppressant-treated LN in Germany, with a high rate of discontinuations, frequent use of high-dose corticosteroids, and substantial HCRU/costs.https://doi.org/10.1007/s40744-023-00623-4Claims analysisCosts and cost analysisImmunosuppressive agentsLupus nephritisTherapeutics |
| spellingShingle | Elena Garal-Pantaler Michael Schultze Mary Elizabeth Georgiou Marc Pignot Kerry Gairy Jacob N. Hunnicutt Real-World Burden of Immunosuppressant-Treated Lupus Nephritis: A German Claims Database Analysis Rheumatology and Therapy Claims analysis Costs and cost analysis Immunosuppressive agents Lupus nephritis Therapeutics |
| title | Real-World Burden of Immunosuppressant-Treated Lupus Nephritis: A German Claims Database Analysis |
| title_full | Real-World Burden of Immunosuppressant-Treated Lupus Nephritis: A German Claims Database Analysis |
| title_fullStr | Real-World Burden of Immunosuppressant-Treated Lupus Nephritis: A German Claims Database Analysis |
| title_full_unstemmed | Real-World Burden of Immunosuppressant-Treated Lupus Nephritis: A German Claims Database Analysis |
| title_short | Real-World Burden of Immunosuppressant-Treated Lupus Nephritis: A German Claims Database Analysis |
| title_sort | real world burden of immunosuppressant treated lupus nephritis a german claims database analysis |
| topic | Claims analysis Costs and cost analysis Immunosuppressive agents Lupus nephritis Therapeutics |
| url | https://doi.org/10.1007/s40744-023-00623-4 |
| work_keys_str_mv | AT elenagaralpantaler realworldburdenofimmunosuppressanttreatedlupusnephritisagermanclaimsdatabaseanalysis AT michaelschultze realworldburdenofimmunosuppressanttreatedlupusnephritisagermanclaimsdatabaseanalysis AT maryelizabethgeorgiou realworldburdenofimmunosuppressanttreatedlupusnephritisagermanclaimsdatabaseanalysis AT marcpignot realworldburdenofimmunosuppressanttreatedlupusnephritisagermanclaimsdatabaseanalysis AT kerrygairy realworldburdenofimmunosuppressanttreatedlupusnephritisagermanclaimsdatabaseanalysis AT jacobnhunnicutt realworldburdenofimmunosuppressanttreatedlupusnephritisagermanclaimsdatabaseanalysis |