Treatment patterns in paediatric and adult patients with SLE: a retrospective claims database study in the USA
Objective To assess real-world treatment regimens and patterns in childhood-onset SLE (cSLE) and adult-onset SLE (aSLE) cohorts, including similarities in treatments, duration of use and adherence.Methods This retrospective study utilised data from Merative L.P. MarketScan Research Databases (USA)....
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-11-01
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| Series: | Lupus Science and Medicine |
| Online Access: | https://lupus.bmj.com/content/10/2/e000817.full |
| _version_ | 1827390987960320000 |
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| author | Hermine I Brunner Nicolino Ruperto Athimalaipet V Ramanan Julie A Birt Christina Dickson Aisha Vadhariya Wallace Crandall Casey Kar-Chan Choong |
| author_facet | Hermine I Brunner Nicolino Ruperto Athimalaipet V Ramanan Julie A Birt Christina Dickson Aisha Vadhariya Wallace Crandall Casey Kar-Chan Choong |
| author_sort | Hermine I Brunner |
| collection | DOAJ |
| description | Objective To assess real-world treatment regimens and patterns in childhood-onset SLE (cSLE) and adult-onset SLE (aSLE) cohorts, including similarities in treatments, duration of use and adherence.Methods This retrospective study utilised data from Merative L.P. MarketScan Research Databases (USA). Index date was the date of first SLE diagnosis (2010–2019). Patients aged <18 years (cSLE) and ≥18 years (aSLE) at index date with confirmed SLE diagnosis and ≥12 months continuous enrolment during pre-index and post-index periods were included. The cohorts were stratified based on the presence (existing) or absence (new) of pre-index SLE. Primary outcomes (post-index period) included treatment regimens (all patients), and adherence (proportion of days covered (PDC)) and discontinuation of therapies initiated within 90 days of diagnosis (new patients). Univariate comparisons between cSLE and aSLE cohorts were performed using Wilcoxon rank-sum and χ2 (or Fisher’s exact) tests.Results cSLE cohort included 1275 patients (mean age=14.1 years) and aSLE cohort included 66 326 patients (mean age=49.7 years). Antimalarials and glucocorticoids were commonly used among new (cSLE=64.4%/62.0%; aSLE=51.8%/49.7%) and existing (cSLE=68.6%/58.9%; aSLE=63.8%/51.3%) patients in both cohorts. Median oral glucocorticoid dose (prednisone equivalent) was higher in cSLE vs aSLE (new=22.1 vs 14.0 mg/day; existing=14.4 vs 12.3 mg/day; p<0.05). Mycophenolate mofetil use was higher in patients with cSLE vs aSLE (new=26.2% vs 5.8%; existing=37.6% vs 11.0%; p<0.0001). Compared with aSLE, more patients used combination therapies in cSLE (p<0.0001). Median PDC was higher in cSLE vs aSLE for antimalarials (0.9 vs 0.8; p<0.0001) and oral glucocorticoids (0.6 vs 0.3; p<0.0001). Treatment discontinuation was lower in cSLE vs aSLE for antimalarials (25.0% vs 33.1%; p<0.0001) and oral glucocorticoids (56.6% vs 71.2%; p<0.0001).Conclusions Management of cSLE and aSLE includes the same medication classes; differences include more intensive use of therapy in cSLE, warranting the need for approved safe medications for cSLE. |
| first_indexed | 2024-03-08T17:02:07Z |
| format | Article |
| id | doaj.art-928331aa61c847fb8168676eff14df7c |
| institution | Directory Open Access Journal |
| issn | 2053-8790 |
| language | English |
| last_indexed | 2024-03-08T17:02:07Z |
| publishDate | 2023-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Lupus Science and Medicine |
| spelling | doaj.art-928331aa61c847fb8168676eff14df7c2024-01-04T08:50:08ZengBMJ Publishing GroupLupus Science and Medicine2053-87902023-11-0110210.1136/lupus-2022-000817Treatment patterns in paediatric and adult patients with SLE: a retrospective claims database study in the USAHermine I Brunner0Nicolino Ruperto1Athimalaipet V Ramanan2Julie A Birt3Christina Dickson4Aisha Vadhariya5Wallace Crandall6Casey Kar-Chan Choong7Cincinnati Children’s Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio, USAIRCCS Istituto Giannina Gaslini, UOC Gaslini Trial Centre/Servizio di Sperimentazioni Cliniche Pediatriche, PRINTO, Genova, ItalyBristol Royal Hospital for Children, Bristol, UKEli Lilly and Company, Indianapolis, Indiana, USA5 Eli Lilly and Company, Indianapolis, Indiana, USAEli Lilly and Company, Indianapolis, Indiana, USAEli Lilly and Company, Indianapolis, Indiana, USAEli Lilly and Company, Indianapolis, Indiana, USAObjective To assess real-world treatment regimens and patterns in childhood-onset SLE (cSLE) and adult-onset SLE (aSLE) cohorts, including similarities in treatments, duration of use and adherence.Methods This retrospective study utilised data from Merative L.P. MarketScan Research Databases (USA). Index date was the date of first SLE diagnosis (2010–2019). Patients aged <18 years (cSLE) and ≥18 years (aSLE) at index date with confirmed SLE diagnosis and ≥12 months continuous enrolment during pre-index and post-index periods were included. The cohorts were stratified based on the presence (existing) or absence (new) of pre-index SLE. Primary outcomes (post-index period) included treatment regimens (all patients), and adherence (proportion of days covered (PDC)) and discontinuation of therapies initiated within 90 days of diagnosis (new patients). Univariate comparisons between cSLE and aSLE cohorts were performed using Wilcoxon rank-sum and χ2 (or Fisher’s exact) tests.Results cSLE cohort included 1275 patients (mean age=14.1 years) and aSLE cohort included 66 326 patients (mean age=49.7 years). Antimalarials and glucocorticoids were commonly used among new (cSLE=64.4%/62.0%; aSLE=51.8%/49.7%) and existing (cSLE=68.6%/58.9%; aSLE=63.8%/51.3%) patients in both cohorts. Median oral glucocorticoid dose (prednisone equivalent) was higher in cSLE vs aSLE (new=22.1 vs 14.0 mg/day; existing=14.4 vs 12.3 mg/day; p<0.05). Mycophenolate mofetil use was higher in patients with cSLE vs aSLE (new=26.2% vs 5.8%; existing=37.6% vs 11.0%; p<0.0001). Compared with aSLE, more patients used combination therapies in cSLE (p<0.0001). Median PDC was higher in cSLE vs aSLE for antimalarials (0.9 vs 0.8; p<0.0001) and oral glucocorticoids (0.6 vs 0.3; p<0.0001). Treatment discontinuation was lower in cSLE vs aSLE for antimalarials (25.0% vs 33.1%; p<0.0001) and oral glucocorticoids (56.6% vs 71.2%; p<0.0001).Conclusions Management of cSLE and aSLE includes the same medication classes; differences include more intensive use of therapy in cSLE, warranting the need for approved safe medications for cSLE.https://lupus.bmj.com/content/10/2/e000817.full |
| spellingShingle | Hermine I Brunner Nicolino Ruperto Athimalaipet V Ramanan Julie A Birt Christina Dickson Aisha Vadhariya Wallace Crandall Casey Kar-Chan Choong Treatment patterns in paediatric and adult patients with SLE: a retrospective claims database study in the USA Lupus Science and Medicine |
| title | Treatment patterns in paediatric and adult patients with SLE: a retrospective claims database study in the USA |
| title_full | Treatment patterns in paediatric and adult patients with SLE: a retrospective claims database study in the USA |
| title_fullStr | Treatment patterns in paediatric and adult patients with SLE: a retrospective claims database study in the USA |
| title_full_unstemmed | Treatment patterns in paediatric and adult patients with SLE: a retrospective claims database study in the USA |
| title_short | Treatment patterns in paediatric and adult patients with SLE: a retrospective claims database study in the USA |
| title_sort | treatment patterns in paediatric and adult patients with sle a retrospective claims database study in the usa |
| url | https://lupus.bmj.com/content/10/2/e000817.full |
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