Session Type: Abstract Submissions (ACR)
Systemic lupus erythematosus (SLE) is a chronic, inflammatory disease which can impact on patients’ Health-Related Quality of Life (HRQoL). This analysis was designed to characterize US SLE patients classified by physicians as having “moderate-to-severe” disease, and to assess their burden of disease compared with those with “mild” disease severity.
Data were extracted from the multi-sponsor Adelphi 2013 Lupus Disease-Specific Program, a multinational survey of clinical practice. US physicians completed Patient Record Forms (PRFs); disease severity was based on physician assessments. Patients self-reported data including EQ-5D and Work Productivity and Activity Impairment Index for SLE (WPAI-Lupus), which were included in Patient Self-Completion Records (PSCs).
PRFs and PSCs were collected from 97 rheumatologists. Of 498 patients, disease severity was classified as “mild” in 355 (71%), and “moderate-to-severe” in 139 (28%) (severity was not specified in 4 patients [1%]). Physician assessment of disease severity was predominantly based on affected organs/symptoms (considered most important by 37% and 40% of rheumatologists, respectively). Only 11% reported test results/clinical assessments as a determinant of SLE severity, with no single disease activity index widely used in clinical practice; 68% rheumatologists reported using their own systematic assessment. Physician assessment of disease severity and control of disease activity were imperfectly correlated: disease activity was controlled in 54% of patients with “moderate-to-severe” disease severity, and partially controlled or uncontrolled in 29% of patients with “mild” disease severity. “Moderate-to-severe” patients initially presented with greater disease severity and organ involvement (13% had skin-only SLE at diagnosis), and more flares per 12 month period (Table), than “mild” patients. Compared to “mild” severity, “moderate-to-severe” SLE severity was associated with a greater impact on HRQoL, which was comparable to rheumatic conditions including rheumatoid arthritis and psoriatic arthritis (Table). Fewer “moderate-to-severe” patients were employed, and a higher proportion required care providers (Table). For both “mild” and “moderate-to-severe” patients, obesity was one of the most common associated comorbidities; the proportion of “moderate-to-severe” patients affected was over double that of “mild” patients (Table).
“Moderate-to-severe” SLE severity was associated with a greater burden of disease than patients with “mild” severity. Data show that disease severity is not consistently assessed in US clinical practice and is a multifaceted concept, imperfectly correlated with control of disease activity. Thus, there is a need for a simple, universal tool to accurately assess SLE disease activity, as well as severity, to inform physician and patient decisions regarding treatment.
AbbVie, Afferent, Amgen, Biogen Idec, Bioventus, BMS, Carbylan, Celgene, Celltrion, CORRONA, Crescendo, Genentech/Roche, GSK, Hospira, Iroko, Janssen, Lilly, Merck, Novartis, Pfizer, Regeneron, Sanofi, SKK, Takeda, UCB, Vertex,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-real-world-characterization-of-us-patients-with-moderate-to-severe-systemic-lupus-erythematosus/