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Remission and low d...
Remission and low disease activity are associated with lower healthcare costs : results from the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort
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- Barber, Megan R.W. (author)
- Cumming School of Medicine
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- Ugarte-Gil, Manuel Francisco (author)
- Hospital Nacional Guillermo Almenara Irigoyen, EsSalud,Scientific University of the South, Lima
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- Hanly, John G. (author)
- Dalhousie University
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- Urowitz, Murray B. (author)
- Toronto Western Hospital
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- St-Pierre, Yvan (author)
- McGill University Health Center
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Gordon, Caroline (author)
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- Bae, Sang Cheol (author)
- Hanyang University Hospital for Rheumatic Disease
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- Romero-Diaz, Juanita (author)
- Salvador Zubirán National Institute of Health Sciences and Nutrition
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- Sanchez-Guerrero, Jorge (author)
- Mount Sinai Hospital of University of Toronto
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- Bernatsky, Sasha (author)
- McGill University Health Center
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- Wallace, Daniel J. (author)
- Cedars-Sinai Medical Center
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- Isenberg, David A. (author)
- University College London
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- Rahman, Anisur (author)
- University College London
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- Merrill, Joan T. (author)
- Oklahoma Medical Research Foundation
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- Fortin, Paul R. (author)
- Laval University
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- Gladman, Dafna D. (author)
- University of Toronto
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- Bruce, Ian N. (author)
- Manchester University NHS Foundation Trust,University of Manchester
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- Petri, Michelle A. (author)
- Johns Hopkins University School of Medicine
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Ginzler, Ellen M. (author)
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- Dooley, Mary Anne (author)
- University of North Carolina
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- Ramsey-Goldman, Rosalind (author)
- Northwestern University Feinberg School of Medicine
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- Manzi, Susan (author)
- Allegheny Health Network
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- Jönsen, Andreas (author)
- Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Lund SLE Research Group,Forskargrupper vid Lunds universitet,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups
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- Van Vollenhoven, Ronald F. (author)
- University of Amsterdam
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- Aranow, Cynthia (author)
- Feinstein Institute for Medical Research
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- Mackay, Meggan (author)
- Feinstein Institute for Medical Research
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- Ruiz-Irastorza, Guillermo (author)
- Hospital de Cruces
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- Lim, S. Sam (author)
- Emory University
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Inanc, Murat (author)
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- Kalunian, Kenneth C. (author)
- University of California, San Diego
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- Jacobsen, Søren (author)
- Copenhagen University Hospital
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- Peschken, Christine A. (author)
- University of Manitoba
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- Kamen, Diane L. (author)
- Medical University of South Carolina
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- Askanase, Anca (author)
- Columbia University
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- Pons-Estel, Bernardo A. (author)
- Grupo Oroño-Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR)
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- Cardwell, Francesca S. (author)
- University of Waterloo
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Alarcón, Graciela S. (author)
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- Clarke, Ann E. (author)
- Cumming School of Medicine
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(creator_code:org_t)
- 2024
- 2024
- English.
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In: Annals of the Rheumatic Diseases. - 0003-4967.
- Related links:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
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- Objectives: This study aims to determine the independent impact of definitions of remission/low disease activity (LDA) on direct/indirect costs (DCs, ICs) in a multicentre inception cohort. Methods: Patients from 31 centres in 10 countries were enrolled within 15 months of diagnosis and assessed annually. Five mutually exclusive disease activity states (DAS) were defined as (1) remission off-treatment: clinical (c) SLEDAI-2K=0, without prednisone/immunosuppressants; (2) remission on-treatment: cSLEDAI-2K=0, prednisone ≤5 mg/day and/or maintenance immunosuppressants; (3) LDA-Toronto Cohort (TC): cSLEDAI-2K≤2, without prednisone/immunosuppressants; (4) modified lupus LDA state (mLLDAS): SLEDAI-2K≤4, no activity in major organs/systems, no new activity, prednisone ≤7.5 mg/day and/or maintenance immunosuppressants and (5) active: all remaining assessments. At each assessment, patients were stratified into the most stringent DAS fulfilled and the proportion of time in a DAS since cohort entry was determined. Annual DCs/ICs (2021 Canadian dollars) were based on healthcare use and lost workforce/non-workforce productivity over the preceding year. The association between the proportion of time in a DAS and annual DC/IC was examined through multivariable random-effects linear regressions. Results: 1692 patients were followed a mean of 9.7 years; 49.0% of assessments were active. Remission/LDA (per 25% increase in time in a remission/LDA state vs active) were associated with lower annual DC/IC: remission off-treatment (DC -$C1372; IC -$C2507), remission on-treatment (DC -$C973; IC -$C2604,) LDA-TC (DC -$C1158) and mLLDAS (DC -$C1040). There were no cost differences between remission/LDA states. Conclusions: Our data suggest that systemic lupus erythematosus patients who achieve remission, both off and on-therapy, and reductions in disease activity incur lower costs than those experiencing persistent disease activity.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)
Keyword
- Economics
- Epidemiology
- Health services research
- Lupus Erythematosus, Systemic
- Risk Factors
Publication and Content Type
- art (subject category)
- ref (subject category)
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Barber, Megan R. ...
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Ugarte-Gil, Manu ...
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Hanly, John G.
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Urowitz, Murray ...
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St-Pierre, Yvan
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Gordon, Caroline
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show more...
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Bae, Sang Cheol
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Romero-Diaz, Jua ...
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Sanchez-Guerrero ...
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Bernatsky, Sasha
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Wallace, Daniel ...
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Isenberg, David ...
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Rahman, Anisur
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Merrill, Joan T.
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Fortin, Paul R.
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Gladman, Dafna D ...
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Bruce, Ian N.
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Petri, Michelle ...
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Ginzler, Ellen M ...
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Dooley, Mary Ann ...
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Ramsey-Goldman, ...
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Manzi, Susan
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Jönsen, Andreas
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Van Vollenhoven, ...
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Aranow, Cynthia
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Mackay, Meggan
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Ruiz-Irastorza, ...
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Lim, S. Sam
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Inanc, Murat
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Kalunian, Kennet ...
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Jacobsen, Søren
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Peschken, Christ ...
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Kamen, Diane L.
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Askanase, Anca
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Pons-Estel, Bern ...
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Cardwell, France ...
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Alarcón, Graciel ...
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Clarke, Ann E.
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Rheumatology and ...
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Annals of the Rh ...
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Lund University