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Real-world impact of flaring on patient-reported outcomes and healthcare resource utilisation in systemic lupus erythematosus
K.H. Costenbader1, B. Hoskin2, C. Atkinson3, D. Bell4, J. Pike5, J.H. Lofland6, P. Berry7, C.S. Karyekar8, Z. Touma9
- Brigham and Women’s Hospital, Boston, MA, USA.
- Adelphi Real World, Bollington, UK. ben.hoskin@adelphigroup.com
- Adelphi Real World, Bollington, UK.
- Adelphi Real World, Bollington, UK.
- Adelphi Real World, Bollington, UK.
- Global Commercial Strategy Organisation, Janssen, Horsham, PA, USA.
- Global Commercial Strategy Organisation, Janssen, Horsham, PA, USA.
- Global Commercial Strategy Organisation, Janssen, Horsham, PA, USA.
- University of Toronto, Toronto, Canada.
CER14972
2022 Vol.40, N°11
PI 2023, PF 2031
Full Papers
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PMID: 34905485 [PubMed]
Received: 07/07/2021
Accepted : 15/11/2021
In Press: 10/12/2021
Published: 04/11/2022
Abstract
OBJECTIVES:
We investigated the association of SLE flares with patient-reported outcomes (PRO) and healthcare resource utilisation (HCRU) using real-world data.
METHODS:
Rheumatologists from the USA, France, Germany, Spain, Italy provided demographic, clinical, and HCRU data for patients with SLE, who provided PRO data. “Flaring” was defined as ≥1 rheumatologist-reported flare in the past 12 months. Demographic/clinical data were analysed descriptively, and findings compared statistically by flaring status. Logistic regression estimated a propensity score for flaring based on ethnicity, disease duration, and severity at diagnosis. Propensity score-matched flaring and non-flaring patients were compared for their HCRU, PROs, income loss and treatment satisfaction.
RESULTS:
Physicians (n=263) provided data for 1,278 patients (408 flaring/870 non-flaring); 729 patients (241 flaring/488 non-flaring) provided matched patient data. Patients had a mean 2.1 flares in the previous 12 months. Propensity score matched analyses indicated worse outcomes and greater HCRU in the past 12 months in flaring than non-flaring patients: EuroQoL 5D-3L Utility Index: 0.72 vs. 0.83; Functional Assessment of Chronic Illness Therapy-Fatigue scale: 30.06 vs. 36.48; Work Productivity and Activity Impairment Index: absenteeism 5.87% vs. 2.53% / presenteeism 33.44% vs. 19.16% / overall work impairment 35.98% vs. 20.66% / total activity impairment 42.47% vs. 30.23%; healthcare consultations (8.10 vs. 6.41), hospitalisations (24.26 vs. 7.63), emergency department visits (20.83 vs. 4.19), tests (46.59 vs. 38.90); current medications (2.76 vs. 2.19) (all p<0.001 except absenteeism, p=0.004).
CONCLUSIONS:
Similar flaring SLE patients had worse PROs and higher HCRU than non-flaring patients, underscoring the need for more effective strategies and treatments to alleviate or prevent flaring.
