#4516 CLINICAL CHARACTERISTICS OF PATIENTS WITH LUPUS NEPHRITIS CLASS III–V: ANALYSIS OF INTERNATIONAL REAL-WORLD DATA

Abstract

Abstract Background and Aims Lupus nephritis (LN) is a severe renal manifestation of systemic lupus erythematosus (SLE) that negatively impacts morbidity and mortality; however, real-world data for LN is scarce. This study describes: the proportion of patients with SLE managed by rheumatologists (rheum-managed) and by nephrologists (neph-managed) with LN class III–V; the proportion of patients with a Safety of Estrogens in Lupus Erythematosus National Assessment - SLE Disease Activity Index (SELENA-SLEDAI) score ≥8 by region; extra-renal organ systems involvement by region; flaring by region; and EQ-5D and EQ-visual analogue scale (VAS) scores by estimated glomerular filtration rate (eGFR). Method Data were drawn from the Adelphi Lupus Disease Specific Programme, a cross-sectional, multi-subscriber survey of physicians and their consulting patients conducted April 2021–May 2022 in China, Japan, EU5 (France, Germany, Italy, Spain and the UK) and the USA. Physicians provided demographic and clinical data for 5–6 consecutive adult patients consulting for SLE/LN. LN class III–V was assessed by the physician at data collection. SELENA-SLEDAI scores were derived by physician assessment of patients’ current clinical manifestations. Patients had the opportunity to complete an EQ-5D form. All analyses were descriptive. Results Overall, 9% (183/2148) of rheum- and 48% (364/766) of neph-managed patients had LN. Most patients with LN had a SELENA-SLEDAI score ≥8 (70% of rheum- and 76% of neph-managed; Table 1), compared with 48% (1032/2148) of rheum-managed patients with SLE alone. The proportion of neph-managed patients with LN with a SELENA-SLEDAI score ≥8 varied by region, from 58% in the USA to 87% in China. In total, 62% of rheum- and 43% of neph-managed patients with LN had ever flared (any organ system; Table 1). The proportion of rheum-managed patients with LN who had ever flared ranged from 52% in China + Japan to 75% in EU5. The proportion of patients with LN currently experiencing a flare was similar between rheum- (31%) and neph-managed (35%) patients, but varied by region, with the highest proportion for rheum-managed patients in China (59%) and lowest in the USA (18%). In subgroups with ≥15 patients, EQ-5D and EQ-VAS scores generally worsened as eGFR lowered (Figure 1). Conclusion Patients with LN class III–V had high disease burden (SELENA-SLEDAI scores ≥8) and flaring that varied by region, suggesting a need for more efficacious treatments for patients with LN.