Anifrolumab is a new therapeutic approach for individuals with systemic lupus erythematosus (SLE) directed at blocking the type 1 interferon pathway. Despite the expanding body of literature on ...Anifrolumab, an essential aspect remains absent: the subjective patient experience of treatment effects and implications on patients’ health-related quality of life (HRQoL). The present study aimed to fill this void by elucidating the nuanced perspectives of SLE patients receiving Anifrolumab treatment by conducting qualitative in-depth interviews (IDIs). SLE patients at Aarhus University Hospital who had received at least three infusions of Anifrolumab were approached for inclusion in the study, which comprised two main elements: (1) qualitative IDIs and (2) collection of patient data from electronic medical records (EMRs). The IDIs were semi-structured and based on a discussion guide that included open-ended and close-ended questions. Verbatim transcripts were coded and analysed using qualitative software to understand concepts important to patients and to understand patients’ own experiences before and after Anifrolumab therapy. A clinical chart review was conducted using EMR data at baseline, 3 months, and 6 months after Anifrolumab initiation. IDIs were completed with 14 patients, and EMR data was collected from 16 patients (treatment days range: 62-474). Of the 23 symptoms spontaneously reported by patients prior to Anifrolumab treatment, fatigue, joint pain, sun sensitivity, joint stiffness, skin rashes, and hair loss were the most common. Most symptoms improved, and none worsened during treatment. Patients reported significant impacts of disease on daily life before treatment: day-to-day activities, social life, emotional aspects, physical activity, concentration/memory, work/employment, and family/romantic relationships. Patients reported improvements in all aspects after treatment but were still impacted. From the EMR data, we observed a fall in disease activity after treatment initiation with a concomitant reduction in the use of corticosteroids. This study provides valuable insights into the subjective experiences of SLE patients treated with Anifrolumab, and the findings collectively contribute to a comprehensive understanding of the treatment’s efficacy from the patients’ perspective and its tangible effects on both subjective and objective parameters in SLE patients.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
ObjectiveAnifrolumab is a new therapeutic approach for individuals with systemic lupus erythematosus (SLE) directed at blocking the type 1 interferon pathway. Despite the expanding body of literature ...on Anifrolumab, an essential aspect remains absent: the subjective patient experience of treatment effects and implications for daily life. The present study aimed to fill this void by elucidating the nuanced perspectives of SLE patients receiving Anifrolumab treatment by conducting qualitative in-depth interviews (IDIs).MethodsSLE patients at Aarhus University Hospital who had received at least 3 infusions of Anifrolumab were approached for inclusion in a study comprising two main elements: 1) Qualitative IDIs and 2) Collection of patient data from electronic medical records (EMRs). The 60-minute IDIs were semi-structured and based on a discussion guide that included both open-ended and close-ended questions. Verbatim transcripts were coded and analyzed using qualitative software to understand concepts important to patients and to understand patients’ own experiences before and after Anifrolumab therapy. A clinical chart review was then conducted using EMR data at baseline, 3 months, and 6 months (where available) after Anifrolumab initiation.ResultsIDIs were successfully conducted with 14 patients and EMR data was collected from 16 patients (treatment days range: 62–474). The symptoms reported most prior to Anifrolumab treatment were fatigue (93%), joint pain (93%), sun sensitivity (86%), skin rashes (79%), and hair loss (71%) (figure 1a). All symptoms improved, although still present, and none worsened during the treatment (figure 1b). Patients reported significant impact of disease on daily life before treatment: day-to-day activities (79%), emotional aspects (71%), social life (71%), physical activity (64%), concentration/memory (57%), work (50%) and family/romantic relationships (50%) (figure 2a). Patients reported improvements on all aspects after treatment but were still impacted (figure 2b). From the EMR data, we observed a fall in disease activity after treatment initiation with a concomitant reduction in the use of corticosteroids.ConclusionsThis study provides valuable insights into the subjective experiences of SLE patients treated with Anifrolumab. These findings collectively contribute to a comprehensive understanding of the treatment’s efficacy and its tangible effects on both subjective and objective parameters in SLE patients.AcknowledgementsThis study was sponsored by AstraZeneca.Abstract P133 Figure 1ASymptom saliency before anifrolumab treatmentAbstract P133 Figure 1BSymptom saliency after anifrolumab treatmentAbstract P133 Figure 2AImpact saliency before anifrolumab treatmentAbstract P133 Figure 2BImpact saliency after anifrolumab treatment
ObjectiveTo estimate the prevalence and incidence of SLE in Sweden using a recent patient cohort, and to estimate the proportion and survival of patients with moderate-to-severe disease defined from ...register data.MethodsThis observational cohort study utilized data from national registries. Adult patients were included if they had at least two secondary care visits with a primary diagnosis of SLE from 1 July 2005 to 31 December 2020.Incident patients were defined as those with no prior visits for SLE in at least the previous 4 years. Disease severity was defined using an algorithm based on previous studies.1 2 Overall survival was defined for incident patients from date of first SLE visit (presumed diagnosis date) until death, stratified by severity in the year after diagnosis.ResultsIn total, 10,186 patients were identified, of which 5,076 were diagnosed after 2006. Prevalence increased from 2006 to 2019. The estimated point prevalence of adult SLE was 93.8 per 100,000 on 31 December 2019, and the estimated average incidence rate between 2015 and 2019 was 4.1 per 100,000 (figure 1). Of incident patients (mean age 49.9, 85% females), 61% had a clinical presentation of moderate-to-severe SLE at some point during the year following diagnosis, however patients can transition between severity states over time. The proportion of patients with moderate-to-severe disease stabilised at around 45% by 4 years after diagnosis until the end of follow-up. Compared to mild SLE patients, moderate-to-severe patients had poorer survival. After 10 years, patients with severe SLE in the year following diagnosis had an 80% survival probability compared to 86% for those with mild SLE (HR 1.49, P<0.001). Patients with moderate SLE had an 81% survival probability (HR vs. mild 1.42, P<0.001) (figure 2).ConclusionsThe estimated incidence and prevalence of SLE in Sweden is consistent with previous studies. This is the first study to evaluate moderate-to-severe SLE in Sweden from registers. Previous research has shown that survival in SLE is poorer than for controls, and we show that survival is poorer in patients presenting with moderate-to-severe disease than in mild disease, highlighting the importance of improving care for this patient group.AcknowledgementsThis study was sponsored by AstraZeneca.References Garris C, Jhingran P, Bass D, et al. Healthcare utilization and cost of systemic lupus erythematosus in a US managed care health plan. J Med Econ 2013;16:667–77. Samnaliev M, Barut V, Weir S, et al. Health care utilization and costs in adults with systemic lupus erythematosus in the United Kingdom: A real-world observational retrospective cohort study. EULAR European E-Congress of Rheumatology. Online2020.Abstract O6 Figure 1Incidence and prevalence of SLE (per 100 000)Abstract O6 Figure 2Kaplan-Meier for mortality by disease severity
Patients with SLE have an increased risk of comorbidities and impaired survival. We aimed to assess whether various thresholds of oral CS (OCS) can predict development of infections, comorbidities, ...malignancies and survival in SLE using data from national health registries in Sweden.
All incident SLE cases, age >18 years, in Sweden (n = 5309) between 2005 and 2020 and matched population controls (n = 26 545) were included and followed until 2020, a total of 257 942 patient years. Data from national registers were retrieved including information from the National Prescribed Drug Register. Risk factors were analysed using time-dependent Cox regression models.
Compared with no OCS, >0 to <5.0 mg/day, 5.0-7.5 mg/day as well as >7.5 mg/day OCS predicted development of infections (pneumonia, influenza, herpes zoster and urinary tract infection), osteoporosis, osteonecrosis, gastroduodenal ulcers, cataracts, hypertension and mortality (all P < 0.05). OCS >0 to <5.0 mg/day was associated with lower hazard ratios for these comorbidities than higher doses of OCS. Fifteen years after diagnosis, 48% of patients were taking OCS at a median dose of 5.7 mg/day. A small reduction of OCS treatment 5 years after diagnosis in patients diagnosed with SLE 2006-10 compared with 2011-15 was observed, 49% vs 46% respectively (P = 0.039).
Results highlight the potential harm associated with even low OCS dose treatment in SLE and the need to judiciously use OCS at the lowest possible dose to maximize efficacy and minimize harm.
