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Abstract Number: 1463

Use of Telemedicine for Follow-up of Lupus Nephritis in the COVID-19 Outbreak: The 6-month Results of a Randomized Controlled Trial

ho SO1, Evelyn Chow1, Isaac Cheng1, Xerox Lau1, Tena Li1, Cheuk Chun Szeto1 and Lai-Shan Tam2, 1The Chinese University of Hong Kong, Hong Kong, Hong Kong, 2Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China (People's Republic)

Meeting: ACR Convergence 2021

Keywords: Systemic lupus erythematosus (SLE)

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Session Information

Date: Monday, November 8, 2021

Session Title: Abstracts: SLE – Treatment: New Agents, Old Agents (1458–1463)

Session Type: Abstract Session

Session Time: 4:45PM-5:00PM

Background/Purpose: Telemedicine (TM) has been widely advocated and used to follow up patients with rheumatic diseases during the COVID-19 outbreak. However, there is no evidence supporting its use in systemic lupus erythematosus. We aimed to evaluate the short-term patient satisfaction, compliance, disease control and infection risk of TM compared with standard in-person follow-up (FU) for patients with lupus nephritis (LN) during the pandemic.

Methods: This was a single-center open-label randomized controlled study. Consecutive patients followed at the LN clinic were randomized to either TM or standard FU (SF) group in a 1:1 ratio. Patients in the TM group received FU via videoconferencing. SF group patients continued conventional in-person outpatient care. The 6-month data were compared and presented.

Results: From June to December 2020, 122 patients were randomized (TM: 60, SF: 62) and had at least 2 FUs. There were no baseline differences, including SLEDAI-2k and proportion of patients in lupus low disease activity state (LLDAS), between the 2 groups except a higher physician global assessment score (PGA) in the TM group (table). After a mean FU of 19.8±4.5 weeks, the overall patient satisfaction score was higher in the TM group with a significantly shorter waiting time from entering the clinic waiting room (virtual or real) to seeing a rheumatologist (figure). More patients in the TM group had hospitalization (15/60, 25.0% vs 7/62, 11.3%; p=0.049) with higher baseline PGA (OR=1.15, 95% CI 1.07-1.23) being the independent predictor. The proportions of patients remained in LLDAS were similar in the 2 groups (TM: 75.0% vs SF: 74.2%, p=0.919). None of the patients had COVID-19.

Conclusion: TM FU resulted in better patient satisfaction and similar short-term disease control in patients with LN compared to standard care. However, it was associated with more hospitalizations and might need to be complemented by in-person visits especially in patients with higher PGA.

Table Baseline clinical data of the recruited patients and comparison between the telemedicine/standard follow-up groups

Figure A. Mean waiting time between entering the clinic waiting room (virtual or real) and seeing a rheumatologist. TM = Telemedicine, SF = Standard follow-up. B. Satisfaction scores of patients who used TM) compared to SF. Response is shown as percentage with positive responses on the right. The neutral category was removed when calculating percentages.


Disclosures: h. SO, None; E. Chow, None; I. Cheng, None; X. Lau, None; T. Li, None; C. Szeto, None; L. Tam, Janssen, 2, 5, Pfizer, 2, 5, GlaxoSmithKline, 5, AbbVie, 2, Novartis, 5, Amgen, 5, Boehringer Ingelheim, 2, 5, Eli Lilly, 2, Sanofi, 2.

To cite this abstract in AMA style:

SO h, Chow E, Cheng I, Lau X, Li T, Szeto C, Tam L. Use of Telemedicine for Follow-up of Lupus Nephritis in the COVID-19 Outbreak: The 6-month Results of a Randomized Controlled Trial [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/use-of-telemedicine-for-follow-up-of-lupus-nephritis-in-the-covid-19-outbreak-the-6-month-results-of-a-randomized-controlled-trial/. Accessed February 3, 2023.
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