gms | German Medical Science

Background: Disease course and drug selection in SLE strongly depend on the type of organ involvement, as demonstrated for patients with lupus nephritis (LN) or central nervous system (CNS) involvement [1], [2]. Therefore, it is of interest to study epidemiologic data of SLE with/without LN and CNS involvement separately. During the last years, introduction of biologics has improved disease burden and prognosis for these patients. However, efficacy was primarily demonstrated in randomized controlled trials, and the evidence in the real-world setting limited.

Methods: In this retrospective claims data analysis, 3,017 adult patients diagnosed with SLE were separated into those without kidney or CNS involvement, with LN or CNS only, and with LN and CNS manifestations between January 2012 and December 2019. Their incidence and prevalence were investigated and extrapolated to the German statutory health insurance population. Out of these, 941 incident patients identified from January 2012 to December 2017 were analyzed for current treatment practice according to guidelines [3]. Steroid use and SLE severity were investigated for up to 3 sequences of therapy (SOTs), as previously described [2], [4]. Biologics available in Germany in the period of data collection were belimumab and rituximab (off-label).

Results: With notable year-to-year fluctuations, incidence rates were stable across the 4 selected cohorts in Germany between 2012 and 2019. In contrast, prevalence rates increased for all 4 cohorts, around 40% for the SLE only and LN cohorts, and up to 100% for the cohorts with CNS lupus (Table 1 [Tab. 1]). Over time, with progression along sequence of therapy, the percentage of mild disease severity decreased (Figure 1 [Fig. 1]). While corticosteroid use was stable across SOTs in SLE only patients, a continuous reduction to lower doses was noted for SLE patients with kidney or CNS involvement.olders of Amgen Inc.

Conclusion: Incidence of SLE is stable, while prevalence is increasing regardless of organ involvement among German patients with statutory health insurance. Our data demonstrate that despite availability of biologics and efforts of corticosteroid reduction, patients across all cohorts progress in their disease severity, indicating a still high potential unmet need for more effective treatments in this disease.

Disclosure: This study was funded by Amgen GmbH.

TA: Speaker/Lecturer for: Abbvie, Amgen, AstraZeneca, Bayer, GSK, Lilly, Medac and Roche; Consultant for: Abbvie, Amgen, Bayer, GSK, Lilly; Research/Grant support from: Amgen, Janssen, Miltenyi.

PS: Speaker/Lecturer for: AXIOM Health, AMGEN, AbbVie, Biogen, Bristol-Myers Squibb, Celgene, Chugai Pharma Marketing Ltd./Chugai Europe, Deutscher Psoriasis-Bund, Gilead Sciences, Galapagos, Hexal Pharma, Janssen-Cilag, Johnson & Johnson, Lilly/Lilly Europe/Lilly Global, medi-login, Mediri GmbH, Novartis Pharma, Onkowissen GmbH, Pfizer, Roche Pharma, Rheumazentrum Rhein-Ruhr, Sanofi-Genzyme, Spirit Medical Communication, Swedish Orphan Biovitrum, UCB Pharma.

Consultant for: AXIOM Health, AMGEN, AbbVie, Biogen, Bristol-Myers Squibb, Celgene, Chugai Pharma Marketing Ltd./Chugai Europe, Deutscher Psoriasis-Bund, Gilead Sciences, Galapagos, Hexal Pharma, Janssen-Cilag, Johnson & Johnson, Lilly / Lilly Europe / Lilly Global, medi-login, Mediri GmbH, Novartis Pharma, Onkowissen GmbH, Pfizer, Roche Pharma, Rheumazentrum Rhein-Ruhr, Sanofi-Genzyme, Spirit Medical Communication, Swedish Orphan Biovitrum, UCB Pharma.

Research/Grant support from: Deutsche Forschungsgesellschaft (DFG), Bundesministerium für Bildung und Forschung (BMBF), AMGEN, AbbVie, BMS, Celgene, Chugai, Deutscher Psoriasis-Bund, Janssen-Cilag, Lilly, Novartis, Roche, Rheumazentrum Rhein-Ruhr, UCB Pharma

JB, TG: Employees of WIG2 GmbH.

MS, ES: Employees of Amgen GmbH; Shareholders of Amgen Inc.