A REAL-WORLD RETROSPECTIVE COHORT STUDY CHARACTERIZING TREATMENT PATTERNS AMONG PATIENTS WITH LUPUS NEPHRITIS IN THE UNITED STATES
Author(s)
Francesca Barion, PhD1, deMauri Mackie, PhD2, Charlotte E. Ward, PhD3, Divya Nagpal, BS4, Jatin Chopra, BS4, Kashish Goyal, BS4;
1argenx, Padova, Italy, 2argenx, Elkins Park, PA, USA, 3ZS Associates, Bethesda, MD, USA, 4ZS Associates, Gurugram, India
1argenx, Padova, Italy, 2argenx, Elkins Park, PA, USA, 3ZS Associates, Bethesda, MD, USA, 4ZS Associates, Gurugram, India
OBJECTIVES: Lupus Nephritis (LN) is a serious renal complication of systemic lupus erythematosus (SLE) and a leading cause of kidney failure. Understanding real-world treatment patterns is critical for optimizing patient outcomes and guiding clinical practice. This study aims to explore the treatment landscape for LN patients using real-world data.
METHODS: We conducted a retrospective cohort study using U.S. administrative claims data (Komodo Health; Jan 2016-Mar 2025). Adults with LN-SLE (N=1,402) were identified based on ≥1 inpatient claim with an LN-SLE diagnosis code (ICD-10: M32.14, M32.15) or ≥2 outpatient claims 30-365 days apart with evidence of glomerular disease, acquired chronic kidney disease, or proteinuria. Continuous enrollment ≥1 year pre-index and ≥3 years post-index was also required.
RESULTS: LN patients frequently received multi-drug regimens, with 48% initiating monotherapy in the first year and mono- versus combination-therapy proportions remaining stable pre- to post-diagnosis (50%). MMF and AZA were the most common monotherapies, while MMF-steroid and AZA-steroid were the most frequent combination regimens. Oral steroid use and average daily dose increased after diagnosis, although LN-specific steroid use decreased during the extended follow-up. Approximately 60% of patients experienced at least one treatment gap within 1 year (mean gap: 82 days). Patients receiving triple therapy with a CNI were older and had higher comorbidity burden compared with belimumab users.
CONCLUSIONS: LN patients demonstrate complex treatment patterns characterized by frequent use of combination regimens, sustained reliance on steroids, and notable treatment gaps within the first year after diagnosis. Variation in treatment intensity, particularly among patients receiving CNI-based triple therapy, reflects differing levels of clinical complexity. These findings highlight ongoing challenges in maintaining continuous and effective therapy for LN.
METHODS: We conducted a retrospective cohort study using U.S. administrative claims data (Komodo Health; Jan 2016-Mar 2025). Adults with LN-SLE (N=1,402) were identified based on ≥1 inpatient claim with an LN-SLE diagnosis code (ICD-10: M32.14, M32.15) or ≥2 outpatient claims 30-365 days apart with evidence of glomerular disease, acquired chronic kidney disease, or proteinuria. Continuous enrollment ≥1 year pre-index and ≥3 years post-index was also required.
RESULTS: LN patients frequently received multi-drug regimens, with 48% initiating monotherapy in the first year and mono- versus combination-therapy proportions remaining stable pre- to post-diagnosis (50%). MMF and AZA were the most common monotherapies, while MMF-steroid and AZA-steroid were the most frequent combination regimens. Oral steroid use and average daily dose increased after diagnosis, although LN-specific steroid use decreased during the extended follow-up. Approximately 60% of patients experienced at least one treatment gap within 1 year (mean gap: 82 days). Patients receiving triple therapy with a CNI were older and had higher comorbidity burden compared with belimumab users.
CONCLUSIONS: LN patients demonstrate complex treatment patterns characterized by frequent use of combination regimens, sustained reliance on steroids, and notable treatment gaps within the first year after diagnosis. Variation in treatment intensity, particularly among patients receiving CNI-based triple therapy, reflects differing levels of clinical complexity. These findings highlight ongoing challenges in maintaining continuous and effective therapy for LN.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO36
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment
Disease
SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain), SDC: Urinary/Kidney Disorders