Treatment trends of systemic lupus erythematosus from 2007 to 2023 in the USA.

IF 3.7 2区医学 Q1 RHEUMATOLOGY

Lupus Science & Medicine Pub Date : 2024-12-09 DOI:10.1136/lupus-2024-001317

Gabriel Figueroa-Parra, Herbert C Heien, Kenneth J Warrington, Nilay D Shah, Cynthia S Crowson, Rozalina G McCoy, Alí Duarte-García

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引用次数: 0

Abstract

Objective: To characterise the changing trends in the pharmacological management of SLE in the USA between 2007 and 2023 as new treatment options emerged.

Methods: In a retrospective cohort study using data from OptumLabs Data Warehouse, we characterised the annual prevalent (ie, all) and incident (ie, new) use of antimalarials, glucocorticoids and immunosuppressive medications among patients with SLE from 2007 to 2023 and assessed for changing trends over time.

Results: We identified 19 122 adults with SLE; they were 51.2 (SD 16.1) years of age, 89% were female, 61.3% were White, 18.5% were Black and 13.1% were Hispanic. The proportion of prevalent users of antimalarials has decreased from 79.4% in 2007 to 77.2% in 2023 (p=0.0055), while the proportion of incident users fluctuated between a lowest 5.8% in 2021 and a highest 8.1% in 2008 (p=0.008). The proportion of prevalent users of glucocorticoids increased from 64.6% in 2007 to 66.7% in 2023 (p=0.0132), as did the proportion of incident users (12.4% in 2007 to 21.7% in 2023; p<0.0001). The use of cyclophosphamide (2.0% in 2007 to 0.4% in 2023, p<0.0001) has decreased; the use of mycophenolate mofetil (7.7% in 2007 to 10.3% in 2023, p<0.0001), rituximab (1.4% in 2007 to 2.1% in 2023, p<0.0001) and belimumab (0.8% in 2011 to 6.1% in 2023, p=0.0001) has increased.

Conclusions: Despite increasing availability of alternative treatment options, patients with SLE in the USA increasingly rely on glucocorticoid-based therapy. Efforts to improve the use of antimalarials and steroid-sparing immunosuppressants are needed.

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2007 - 2023年美国系统性红斑狼疮的治疗趋势

目的：描述2007年至2023年间，随着新的治疗方案的出现，美国SLE药理学管理的变化趋势。方法：在一项使用OptumLabs数据仓库数据的回顾性队列研究中，我们描述了2007年至2023年SLE患者中抗疟药、糖皮质激素和免疫抑制药物的年度流行（即所有）和事件（即新）使用情况，并评估了随时间的变化趋势。结果：我们确定了19 122例SLE成人患者；年龄为51.2 （SD 16.1）岁，女性占89%，白人占61.3%，黑人占18.5%，西班牙裔占13.1%。抗疟药物普遍使用者的比例从2007年的79.4%下降到2023年的77.2% (p=0.0055)，而意外使用者的比例在2021年最低的5.8%和2008年最高的8.1%之间波动（p=0.008）。糖皮质激素普遍使用者的比例从2007年的64.6%增加到2023年的66.7% (p=0.0132)，意外使用者的比例也从2007年的12.4%增加到2023年的21.7%；结论：尽管替代治疗方案越来越多，但美国SLE患者越来越依赖糖皮质激素为基础的治疗。需要努力改进抗疟药和保留类固醇的免疫抑制剂的使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lupus Science & Medicine RHEUMATOLOGY-

CiteScore

5.30

自引率

7.70%

发文量

审稿时长

15 weeks

期刊介绍： Lupus Science & Medicine is a global, peer reviewed, open access online journal that provides a central point for publication of basic, clinical, translational, and epidemiological studies of all aspects of lupus and related diseases. It is the first lupus-specific open access journal in the world and was developed in response to the need for a barrier-free forum for publication of groundbreaking studies in lupus. The journal publishes research on lupus from fields including, but not limited to: rheumatology, dermatology, nephrology, immunology, pediatrics, cardiology, hepatology, pulmonology, obstetrics and gynecology, and psychiatry.