Treatment of systemic lupus erythematosus: Analysis of treatment patterns in adult and paediatric patients across four European countries.

Autor: Du M; Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK., Dernie F; Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK; Medical Sciences Division, University of Oxford, Oxford, UK., Català M; Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK., Delmestri A; Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK., Man WY; Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK., Brash JT; IQVIA, Real World Solutions, Brighton, UK., van Ballegooijen H; IQVIA Solutions B.V, Amsterdam, the Netherlands., Mercadé-Besora N; Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain., Duarte-Salles T; Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain; Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands., Mayer MA; Management and Control Department, Hospital del Mar, Barcelona, Spain; Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain., Leis A; Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain; Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Research Institute (IMIM), Barcelona, Spain., Ramírez-Anguita JM; Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain; Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Research Institute (IMIM), Barcelona, Spain., Griffier R; University Hospital of Bordeaux, Public Health Department, Medical Information Service, Medical Informatics and Archiving Unit (IAM) F-33000 Bordeaux, France., Verdy G; University Hospital of Bordeaux, Public Health Department, Medical Information Service, Medical Informatics and Archiving Unit (IAM) F-33000 Bordeaux, France., Prats-Uribe A; Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK., Pacurariu A; Data Analytics and Methods Task Force, European Medicines Agency, Amsterdam, The Netherlands., Morales DR; Data Analytics and Methods Task Force, European Medicines Agency, Amsterdam, The Netherlands., De Lisa R; Paediatric Medicines Office, Scientific Evidence Generation Department, European Medicines Agency, Amsterdam, The Netherlands., Galluzzo S; Italian Medicine Agency (AIFA), Rome, Italy, Committee of the European Medicines Agency (EMA), Amsterdam, The Netherlands; Pediatric Committee of the European Medicines Agency (EMA), Amsterdam, The Netherlands., Egger GF; Paediatric Medicines Office, Scientific Evidence Generation Department, European Medicines Agency, Amsterdam, The Netherlands., Prieto-Alhambra D; Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK. Electronic address: daniel.prietoalhambra@ndorms.ox.ac.uk., Tan EH; Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK.
Jazyk: angličtina
Zdroj: European journal of internal medicine [Eur J Intern Med] 2024 Aug 11. Date of Electronic Publication: 2024 Aug 11.
DOI: 10.1016/j.ejim.2024.08.008
Abstrakt: 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.
Competing Interests: Declarations of competing interest DPA's department has received grant/s from Amgen, Chiesi-Taylor, Lilly, Janssen, Novartis, and UCB Biopharma. His research group has received consultancy fees from Astra Zeneca and UCB Biopharma. Amgen, Astellas, Janssen, Synapse Management Partners and UCB Biopharma have funded or supported training programmes organised by DPA's department. James Brash and Hanne van Ballegooijen are employees of IQVIA. All other authors have no conflicts of interest to declare.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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