FRI0201 REAL WORLD MEDICATION USE IN INCIDENT SYSTEMIC LUPUS ERYTHEMATOSUS AND LUPUS NEPHRITIS PATIENTS

Abstract

Background Systemic lupus erythematosus (SLE) is an autoimmune disease that causes inflammation in connective tissues and can involve multiple organs systems. Lupus nephritis (LN) is an inflammatory kidney disease caused by SLE. There is a gap in the literature regarding the standard of care in SLE and LN patients. Objectives This study generated real world medication use among SLE and LN patients. Methods This retrospective study used data from two large administrative databases in the US: Truven Health MarketScan® and Optum® databases to identify adult patients (≥18 years of age) with ≥2 medical claims on different dates for SLE or LN diagnoses from 01JAN2013-31DEC2015. SLE was identified using the International Classification of Diseases, 9th and 10th Revision, Clinical Modification [ICD-9-CM] codes (710.0) OR ICD-10-CM (M32.10-M32.19, 32.8, 32.9). LN was captured as a subset of SLE using [ICD-9-CM: 710.0 AND (581.81 or 582.81 or 583.81); OR (ICD-10-CM:M32.14)]. The first SLE or LN diagnosis was designated as the index date. Patients were required to have continuous health plan enrollment for 1 year pre-index date (baseline period) and 1 year post-index date (follow-up period) and no prior SLE/LN diagnosis claims or belimumab medical/prescription claim during the baseline period to ensure incident patients were captured. The Truven Health MarketScan® and Optum® databases were pooled together and duplicates were identified and retained in MarketScan® only. Patient demographics and clinical characteristics during the baseline period were assessed. SLE treatment used during the follow-up period was evaluated and the proportion of patients that used SLE medications and average number of medical/prescription claims (#Rx) for each medication were provided. Results A total of 31,345 patients were identified including 30,086 SLE and 1,259 LN patients. Key results are shown in Table 1. The mean age was 52.7 years for SLE and 48.3 years for LN patients. Over 80% of the patients were female, with a mean Charlson Comorbidity Index (CCI) score of 1.1 and 1.8 for SLE and LN patients respectively. The most common comorbidities at baseline were hypertension and infections. Corticosteroids (SLE= 58.3%, #Rx=4.5; LN=66.2%, #Rx=6.5) and hydroxychloroquine (SLE=43.4%, #Rx=5.8; LN=40.7% #Rx=6.2) were the most commonly used SLE medications during 1-year follow up period. Approximately 2% of patients used biologics including belimumab (SLE=1.1%, #Rx=8.8; LN=1.4%, #Rx=8.3) and rituximab (SLE=0.9%, #Rx=4.2; LN=2.1%, #Rx=4.0). Conclusion Our findings indicate a nominal use of biologics (∼2%) among SLE and LN patients. Corticosteroids and hydroxychloroquine were the most commonly used SLE treatments. These data reveal an unmet need for availability of advanced therapy to treat SLE and LN. Future studies are warranted to understand the underlying causes. Disclosure of Interests: Lin Xie Grant/research support from: Janssen Research & Development, LLC, Furaha Kariburyo Grant/research support from: Janssen Research & Development, LLC, Janvi Sah Grant/research support from: Janssen Research & Development, LLC, Jennifer H. Lofland Employee of: Janssen Global Commercial Strategic Organization, Nan Li Shareholder of: J&J, Employee of: Janssen Scientific Affairs, LLC