TY - JOUR
T1 - Treatment of systemic lupus erythematosus
T2 - Analysis of treatment patterns in adult and paediatric patients across four European countries
AU - Du, Mike
AU - Dernie, Francesco
AU - Català, Martí
AU - Delmestri, Antonella
AU - Man, Wai Yi
AU - Brash, James T.
AU - van Ballegooijen, Hanne
AU - Mercadé-Besora, Núria
AU - Duarte-Salles, Talita
AU - Mayer, Miguel Angel
AU - Leis, Angela
AU - Ramírez-Anguita, Juan Manuel
AU - Griffier, Romain
AU - Verdy, Guillaume
AU - Prats-Uribe, Albert
AU - Pacurariu, Alexandra
AU - Morales, Daniel R.
AU - De Lisa, Roberto
AU - Galluzzo, Sara
AU - Egger, Gunter F.
AU - Prieto-Alhambra, Daniel
AU - Tan, Eng Hooi
N1 - Publisher Copyright:
© 2024
PY - 2024/12/2
Y1 - 2024/12/2
N2 - Objective Multiple treatment options are recommended for Systemic Lupus Erythematosus (SLE) by clinical guidelines. This study aimed to explore SLE treatment patterns as there is limited real-world data of SLE medication utilisation, especially in childhood-onset SLE (cSLE). Methods We conducted a longitudinal cohort study using five routinely collected healthcare databases from four European countries (United Kingdom, France, Germany, and Spain). We described the characteristics of adult and paediatric patients at time of SLE diagnosis. We calculated the percentage of patients commencing SLE treatments in the first month and year after diagnosis, reported number of prescriptions, starting dose, cumulative dose, and duration of each treatment, and characterised the line of therapy. Results We characterised 11,255 patients with a first diagnosis of SLE and included 5718 in our medication utilisation analyses. The majority of adult SLE patients were female (range 80–88 %), with median age of 49 to 54 years at diagnosis. In the paediatric cohort (n = 378), 66–83 % of SLE patients were female, with median age of 12 to 16 years at diagnosis. Hydroxychloroquine and glucocorticoids were common first-line treatments in both adults and children, with second-line treatments including mycophenolate mofetil and methotrexate. Few cases of monoclonal antibody use were seen in either cohort. Initial glucocorticoid dosing in paediatric patients was often higher than in adults. Conclusion Treatment choices for adult SLE patients across four European countries were in line with recent therapeutic consensus guidelines. High glucocorticoid prescriptions in paediatric patients suggests the need for steroid-sparing treatment alternatives and paediatric specific guidelines.
AB - Objective Multiple treatment options are recommended for Systemic Lupus Erythematosus (SLE) by clinical guidelines. This study aimed to explore SLE treatment patterns as there is limited real-world data of SLE medication utilisation, especially in childhood-onset SLE (cSLE). Methods We conducted a longitudinal cohort study using five routinely collected healthcare databases from four European countries (United Kingdom, France, Germany, and Spain). We described the characteristics of adult and paediatric patients at time of SLE diagnosis. We calculated the percentage of patients commencing SLE treatments in the first month and year after diagnosis, reported number of prescriptions, starting dose, cumulative dose, and duration of each treatment, and characterised the line of therapy. Results We characterised 11,255 patients with a first diagnosis of SLE and included 5718 in our medication utilisation analyses. The majority of adult SLE patients were female (range 80–88 %), with median age of 49 to 54 years at diagnosis. In the paediatric cohort (n = 378), 66–83 % of SLE patients were female, with median age of 12 to 16 years at diagnosis. Hydroxychloroquine and glucocorticoids were common first-line treatments in both adults and children, with second-line treatments including mycophenolate mofetil and methotrexate. Few cases of monoclonal antibody use were seen in either cohort. Initial glucocorticoid dosing in paediatric patients was often higher than in adults. Conclusion Treatment choices for adult SLE patients across four European countries were in line with recent therapeutic consensus guidelines. High glucocorticoid prescriptions in paediatric patients suggests the need for steroid-sparing treatment alternatives and paediatric specific guidelines.
KW - Drug utilisation
KW - Epidemiology
KW - Lupus
KW - Real world evidence
KW - Systemic lupus erythematosus
UR - http://www.scopus.com/inward/record.url?scp=85201079437&partnerID=8YFLogxK
U2 - 10.1016/j.ejim.2024.08.008
DO - 10.1016/j.ejim.2024.08.008
M3 - Article
C2 - 39134452
AN - SCOPUS:85201079437
SN - 0953-6205
VL - 130
SP - 106
EP - 117
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
ER -