Characterizing the Burden and Unmet Need of Lupus Nephritis

OBJECTIVES: Lupus nephritis (LN) is a renal disorder of varying severity that occurs as a complication of systemic lupus erythematosus (SLE) and negatively impacts patient outcomes and health-related quality of life (HRQL). This review aims to highlight the disease burden of LN including epidemiology, clinical, humanistic, and economic outcomes, and identify unmet needs and gaps in current knowledge.

METHODS: A targeted literature search was conducted to identify relevant papers published between January 2013 and August 2023 in the following scope markets: US, UK, Germany, France, China, and Japan.

RESULTS: LN occurs in 20%-38% of patients with SLE, with a US incidence of 1:100,000. Higher rates are reported among older individuals, females, and African Americans. There is a significant lack of epidemiological data from other regions, highlighting the need for further studies. Patients with LN face substantial clinical challenges: after 5-10 years of LN diagnosis, 21%-37% develop end-stage renal disease (ESRD), requiring dialysis or kidney transplantation. Ten-year survival rates range from 70% to 88%. Patients with active LN have poorer HRQL compared with those in remission; however, currently available patient-reported outcome tools do not adequately capture LN symptoms, indicating the need for a disease-specific tool. In the US, SLE patients with active LN or ESRD incur higher healthcare resource utilization costs, mainly from inpatient stays. A lack of economic data from other regions underscores the necessity for further research.

CONCLUSIONS: While there are a lot of published data on the burden of LN, some key gaps still remain, including local and regional prevalence rates and non-US data on economic burden. Future research should prioritize these areas, leveraging the use of real-world evidence studies to inform payer decisions and improve patient care.