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Real-world impact of flaring on patient-reported outcomes and healthcare resource utilisation in systemic lupus erythematosus


1, 2, 3, 4, 5, 6, 7, 8, 9

 

  1. Brigham and Women’s Hospital, Boston, MA, USA.
  2. Adelphi Real World, Bollington, UK. ben.hoskin@adelphigroup.com
  3. Adelphi Real World, Bollington, UK.
  4. Adelphi Real World, Bollington, UK.
  5. Adelphi Real World, Bollington, UK.
  6. Global Commercial Strategy Organisation, Janssen, Horsham, PA, USA.
  7. Global Commercial Strategy Organisation, Janssen, Horsham, PA, USA.
  8. Global Commercial Strategy Organisation, Janssen, Horsham, PA, USA.
  9. University of Toronto, Toronto, Canada.

CER14972
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PMID: 34905485 [PubMed]

Received: 07/07/2021
Accepted : 15/11/2021
In Press: 10/12/2021

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.

DOI: https://doi.org/10.55563/clinexprheumatol/k9yyeq

Rheumatology Article

Rheumatology Addendum