Increased Polypharmacy in SLE Patients Save

A cross-sectional study of US adults with systemic lupus erythematosus (SLE) shows significantly increased prevalence of polypharmacy, related to age, disease outcomes and often, non-SLE common medications.

A population-based cohort of adults SLE patients in Atlanta, Georgia were analyzed for both prescribed and over-the-counter (OTC) medications. Polypharmacy was defined as five or more prescription or OTC medications. 

More than half (56%) of 451 SLE patients (15.3% ≥60 yrs, 92% women, 82% Black) reported polypharmacy. 

Factors associated with increased polypharmacy were numerous: 

• Increases with age. Older age (68% for those ≥60 years)
• Higher vs lower disease activity (66% vs 46%)
• SLE-related damage (69% vs 42%)
• Longer disease duration (62% vs 50%)
• Number of immunosuppressants: 3-5 IS=80%;  0-1 IS=38%

Polypharmacy was not statistically significantly different by sex, race, or education. 

Although hydroxychloroquine (71%), glucocorticoids (44%), and other immunomodulating drugs (50%) were common, polypharmacy was most often driven by other medications, such as antihypertensives (62%), nonopioid pain relievers (52%), allergy treatments (22%), antidepressants (22%), and gastric reflux medications (22%).

Clinicians need to address the burden of medication regimens, taking into consideration both OTC and non-SLE medications.