Ab0512 incidence, Prevalence and Current Treatment Practice of Systemic Lupus Erythematosus: A German Claims Data Analysis

Abstract

BackgroundDespite recent advances in the management of systemic lupus erythematosus (SLE), patients still suffer from reduced quality of life and increased mortality compared to the general population [1]. The latest data for Germany report a prevalence of 38.6 - 55.8 cases per 100,000 between 2009 and 2014, however more recent data as well as investigations on treatment algorithms in a real world setting are limited [2].ObjectivesTo investigate incidence and prevalence of SLE for Germany and to evaluate treatment sequences in adult patients with SLE in Germany.MethodsIn this retrospective claims data analysis, 3017 patients with SLE diagnosis between January 2012 and December 2019 were identified for incidence and prevalence analysis. Out of these, 941 incident patients between January 2012 and December 2017 were selected for analysis of current treatment practice. For this analysis, only patients initiating SLE treatment according to guidelines were considered [1]. The date of the earliest prescription for SLE treatment on or following the SLE diagnosis (index date) was defined as start of sequence of therapy (SOT) 1. A new treatment added or switched to resulted in a new SOT. Up to 3 SOTs were measured during follow-up. SLE severity was recorded as previously described [2].ResultsIncidence rates were stable in both genders in Germany between 2012 and 2019, with women showing 3-4 fold higher incidence rates than men. In contrast, prevalence was rising from 40.5 in 2012 to 59.9 per 100,000 people in 2019, with a stronger trend in female patients (Figure 1). The mean (SD) age of the 941 incident patients identified for the treatment practice analysis was 50.6 (15.5) years, 74.4% were female and the mean (SD) follow-up duration was 1836 (634) days. 681 (70.3%) patients initiated SLE treatment (SOT1), with 246 (26.1%) progressing on to SOT2 and 113 (16.6%) on to SOT3. Monotherapies were most commonly prescribed in SOT1 (52.4%), while the use of combination therapies increases with SOT (SOT1 47.6%, SOT2 76.8%, SOT3 77.9%). Antimalarials in combination with corticosteroids were the most prescribed therapy during SOT1 (30.1%), immunosuppressants combined with corticosteroids during SOT2 (32.5%) and antimalarials combined with immunosuppressants and corticosteroids in SOT3 (36.3%). Combination therapies with biologics were used in 2.5% of patients in SOT2 and 8.8% of patients in SOT3 (Table 1). Disease severity increases with SOT.Figure 1Table 1Type of therapySOT1 (n=681)SOT2 (n=246)SOT3 (n=113)Monotherapy - n(%)357(52.42%)57(23.17%)25(22.12%)Antimalarials129(18.94%)28(11.38%)10(8.85%)Immunosuppressants15(2.20%)25(10.16%)14(12.39%)Biologics1(0.15%)4(1.63%)1(0.88%)Intravenous Immunoglobulins1(0.15%)0(0.00%)0(0.00%)Corticosteroids211(30.98%)0(0.00%)0(0.00%)Combination therapies - n(%)324(47.58%)189(76.83%)88(77.88%)Antimalarials + IS7(1.03%)4(1.63%)2(1.77%)Antimalarials + IS + CS42(6.17%)49(19.92%)41(36.28%)Antimalarials + biologics + CS1(0.15%)1(0.41%)3(2.65%)Antimalarials + biologics0(0.00%)0(0.00%)1(0.88%)Antimalarials + CS205(30.10%)50(20.33%)15(13.27%)Antimalarials + IS + biologics + CS0(0.00%)3(1.22%)0(0.00%)IS + CS68(9.99%)80(32.52%)20(17.70%)IS + biologics0(0.00%)0(0.00%)1(0.88%)IS + biologics + CS1(0.15%)1(0.41%)0(0.00%)Biologics + CS0(0.00%)1(0.41%)5(4.42%)IS … Immunosuppressants, CS … CorticosteroidsConclusionWhile incidence of SLE is stable, prevalence is rising among German patients with statutory health insurance. Our data show that for newly diagnosed patients a combination of medication frequently including corticosteroids is required over time to control their disease. These data suggest a persistent unmet need for more effective treatment strategies for better SLE disease management and complement a recent US claims data analysis [3].References[1]Fanouriakis A, et al.Ann Rheum Dis.2019;78(6):736-745.[2]Schwarting A, et al.Rheumatol Ther.2021;8:375-393.[3]Masurkar P, et al.Arthritis Rheumatol.2022; 74 (suppl 9).AcknowledgementsThis study was funded by Amgen GmbH.Disclosure of InterestsTobias Alexander Speakers bureau: Abbvie, Amgen, AstraZeneca, Bayer, GSK, Lilly, Medac, Roche, Consultant of: Abbvie, Amgen, Bayer, GSK, Lilly, Grant/research support from: Amgen, Janssen, Miltenyi, Marcus Schulte Shareholder of: AMGEN Inc., Employee of: AMGEN GmbH, Julia Borchert: None declared, Tarcyane Garcia: None declared, Eva Schrom Shareholder of: Amgen Inc., Employee of: Amgen GmbH.