SLE Cost of Care and Disease Activity Save

A longitudinal, multinational study shows that SLE patients achieving remission or low disease activity incur lower overall direct/indirect (DCs, ICs) healthcare costs than those with persistent activity. 

The study included 1692 SLE from the Systemic Lupus International Collaborating Clinics (SLICC) cohort with patients from 31 centres, 10 countries, all enrolled within 15 months of diagnosis and assessed annually. Patients disease activity states (DAS) were defined as: 

1. remission off-treatment: SLEDAI-2K=0, without prednisone/immunosuppressants

2. remission on-treatment: SLEDAI-2K=0, prednisone ≤5 mg/day and/or maintenance immunosuppressants

3. LDA-Toronto Cohort (TC): cSLEDAI-2K≤2, without prednisone/immunosuppressants

4. modified lupus LDA state (mLLDAS): SLEDAI-2K≤4, no activity in major organs/systems, no new activity, prednisone ≤7.5 mg/day and/or maintenance immunosuppressants 

5. active SLE: all remaining assessments.

Key Findings 

• Mean of followup of 9.7 years

• 49% of assessments were active

• Remission/LDA patients had lower annual DC/IC

  • Remission off-treatment (DC −$C1372; IC −$C2507)

  • remission on-treatment (DC −$C973; IC −$C2604,) 

  • LDA-TC (DC −$C1158) and mLLDAS (DC −$C1040). 

• There were no cost differences between remission/LDA states.

Achieving remission, either off or on therapy, results in lower costs of care in SLE patients.