AB0554 CLINICAL CHARACTERISTICS AND BURDEN AMONG PATIENTS WITH SLE STRATIFIED BY SLEDAI DERIVED SEVERITY: RESULTS FROM A REAL-WORLD STUDY IN THE US

Abstract

BackgroundData are limited concerning the distribution of Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores among patients with SLE in clinical practice and the characteristics of patients with specific SLEDAI scores.ObjectivesTo investigate SLE patient demographics, clinical status, treatment patterns, and patient reported outcomes (PROs), overall and stratified by SLEDAI score.MethodsData were drawn from the Adelphi Real World Lupus IV (2021) Disease Specific Programme™, a point-in-time survey of 79 US rheumatologists and patients with SLE. Rheumatologists completed questionnaires regarding patient demographics, clinical status, and treatment. The same patients were invited to complete questionnaires containing the EuroQoL 5-Dimensions (EQ-5D), Functional Assessment of Chronic Illness Therapy Fatigue Subscale (FACIT-Fatigue) and Work Productivity & Activity Impairment questionnaire (WPAI) Patient-Reported Outcomes (PRO) tools.Physicians completed 24 questions based on the SLEDAI-2K questionnaire regarding their patients’ current clinical manifestations, from which a SLEDAI score was derived1. Patients were grouped based on their score: SLEDAI=0 (none), SLEDAI=1-6 (mild), SLEDAI=7-12 (moderate), and SLEDAI>12 (severe)2.Data from patients without rheumatologist-perceived renal organ involvement and ≥ 1 year of SLE duration were included for analysis using bivariate tests.ResultsA total of 273 patients were included in this analysis. Mean [SD] patient age was 47.0[14.2] years, 83.9% were female, 57.1% were White/Caucasian, and 24.9% were African American.Table 1.Point-in-time clinical status, treatment patterns and PROs among patients with SLE stratified by SLEDAI scoreTable 1.Total Sample (n=273)SLEDAI=0 (n=60, 22%)SLEDAI=1-6 (n=79, 28.9%)SLEDAI=7-12 (n=70, 25.6%)SLEDAI>12 (n=64, 23.4%)p valuePhysician-Reported Clinical Status and Treatment HistoryCurrent SLE severity, n(%)Mild221 (81.0)51 (85.0)70 (88.6)53 (75.7)47 (73.4)0.057Moderate49 (18.0)9 (15.0)9 (11.4)16 (22.9)15 (23.4)Severe3 (1.1)0 (0.0)0 (0.0)1 (1.4)2 (3.1)Current joint symptoms, n(%)Joint tenderness109 (39.9)24 (40.0)27 (34.2)28 (40.0)30 (46.9)0.498Joint stiffness121 (44.3)22 (36.7)33 (41.8)37 (52.9)29 (45.3)0.293Joint swelling60 (22.0)17 (28.3)13 (16.5)19 (27.1)11 (17.2)0.190Mean [SD] Flares in the last 12 months1.6 [1.5]1.3 [1.2]1.7 [1.7]1.5 [1.3]1.8 [1.5]0.550Currently prescribed, n(%)Belimumab58 (21.3)14 (23.3)18 (12.9)8 (10.1)15 (21.4)0.011Immunosuppressants48 (17.6)7 (11.7)26 (18.6)10 (12.7)13 (18.6)0.052Corticosteroids138 (50.6)35 (58.3)62 (44.3)29 (36.7)32 (45.7)0.003Antimalarials206 (75.5)28 (46.7)108 (77.1)64 (81.0)59 (84.3)<0.001Patient-Reported OutcomesMean [SD] EQ5D-5L Utility score (0=death to 1= full health)0.79 [0.19]0.83 [0.12]0.82 [0.21]0.79 [0.14]0.69 [0.25]0.024Mean [SD] FACIT-Fatigue score (0=worst fatigue to 52= no fatigue)32.7 [12.2]36.8 [8.7]36.1 [12.5]29.1 [9.8]26.4 [14.3]<0.001Mean [SD] WPAI overall (0= no impact to 100= completely impacted)26.8 [21.2]25.2 [15.8]19.5 [23.6]35.7 [20.2]31.9 [26.7]0.13149% of SLE patients were categorized as SLEDAI 7-12 or >12 (moderate or severe).Among the SLEDAI 7-12 (moderate) patients, 75.7% were subjectively categorized by their physician as having mild SLE. Of the SLEDAI >12 patients (severe), 73.4% were categorized as having mild SLE.Joints symptoms and flaring in the last 12 months were not significantly different across SLEDAI groups.Patients with greater SLEDAI reported lower EQ5D and greater FACIT-Fatigue scores. There was no statistical difference in WPAI between the SLEDAI groups.ConclusionA disconnect between point-in-time SLEDAI and physician-perceived severity exists. Patients with SLE, irrespective of SLEDAI, had high prevalence of joint symptoms, but higher SLEDAI impacted quality of life.References[1]Gladman D et al., Journal of Rheumatology, 2002.[2]Fanouriakis A et al., Annals of the rheumatic diseases, 2019.Disclosure of InterestsAisha Vadhariya Employee of: Eli Lilly and Company, Julie Birt Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Jianmin Wu Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Kirstin Griffing Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Fiona Bailey: None declared, James Hetherington: None declared, Elke Rottier: None declared, Sophie Barlow: None declared, Karen Costenbader Consultant of: Lilly, Astra Zeneca, Janssen, Amgen, Glaxo Smith Kline, Grant/research support from: Exagen, Gilead, Merck