Systemic lupus erythematosus and associated organ damage in real-world settings: estimating damage scores using...

The Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) captures organ damage (OD) in patients with systemic lupus erythematosus (SLE). However, SDI is not always documented in the clinic or medical claims data. This non-interventional retrospective cohort study (GSK Study 209523) used a claims-based algorithm to estimate annual damage scores and associated economic burden in patients with SLE in Germany.

Patients were identified from the Betriebskrankenkassen German Sickness Fund Database based on the first recorded SLE diagnosis code (index). A claims-based algorithm incorporating conditions listed in the SDI was used to identify OD and estimate damage scores for each follow-up year. Annual costs were estimated from inpatient and outpatient resources and stratified by a damage score point increase.

Patients with SLE (n=2121; pre-existing: n=1037; newly diagnosed: n=1084) and without SLE (n=6308) were included. At baseline, 60.5% (n=1283) of patients with SLE had OD, including 55.3% (n=599) newly diagnosed patients. In Year 1, the mean damage score was 1.82 among all patients with SLE; it was similar between patients with baseline OD and pre-existing (2.76) and newly diagnosed SLE (2.89). Among patients with SLE, during years with a 1-, 2- and ≥3-point increase in damage score, median annual costs were 1.94, 3.75 and 7.84 times those in years without damage score increase.

Our findings suggest that real-world administrative claims data can effectively estimate damage scores in patients with SLE, and that the increase in scores correlates with a higher economic burden.