BURDEN OF LUPUS NEPHRITIS IN THE BRAZILIAN PUBLIC HEALTH SYSTEM PERSPECTIVE: A REAL-WORLD STUDY
Author(s)
Edgard Reis-Neto, PhD1, Iago D. Silveira, BS2, Larissa Acerbi, BS2, Henrique Lima, BS2, Clarissa Medeiros, MSc2, Veronica E. Mata, MBA, MSc, PhD3;
1Escola Paulista de Medicina / Federal University of São Paulo, São Paulo, Brazil, 2Produtos Roche Químicos e Farmacêuticos S/A, São Paulo, Brazil, 3F. Hoffman-La Roche, Market access & HTA Manager, SAO PAULO, Brazil
1Escola Paulista de Medicina / Federal University of São Paulo, São Paulo, Brazil, 2Produtos Roche Químicos e Farmacêuticos S/A, São Paulo, Brazil, 3F. Hoffman-La Roche, Market access & HTA Manager, SAO PAULO, Brazil
OBJECTIVES: Analyze time intervals from Systemic Lupus Erythematosus (SLE) first attendance to dialysis initiation and displacement in Lupus Nephritis (LN) patients aged ≥18 years within the Brazilian Unified Health System (SUS).
METHODS: This retrospective study analyzed anonymized claim data of patients from 2023 Outpatient Information System of SUS (SIA-SUS). LN patients were defined by SLE diagnosis (ICD-10 M32) and recorded dialysis, specific immunosuppressant treatment with nephrology care, ≥2 nephrology visits, or renal disease treatment. Patient displacement (distance and time) was estimated by combining SIA-SUS, Brazilian Institute of Geography and Statistics, and OpenStreetMap data using R software.
RESULTS: In 2023, 15,580 LN patients were identified; 1,503 (9.6%) were on dialysis, with 50.9% initiating dialysis before SLE diagnosis, reflecting severe progression. Geolocation analysis of 1,233 patients showed most resided in the Southeast (44.0%) and Northeast (27.4%). Median travel to dialysis was 28.8 km (37 minutes). Distances were longest in the Northeast (38 km, 47 minutes) and shortest in the Southeast (27.2 km, 37 minutes). Notably, 42.0% traveled outside their municipality for dialysis, with the Northeast recording 52.8%. Travel distribution showed 6.6% traveled over 250 km, 14.7% between 100-250 km, 13.7% between 50-100 km, and 65.0% under 50 km.
CONCLUSIONS: This study shows a critical disease burden for LN patients in the SUS, characterized by late nephrological intervention and significant logistical barriers. The critical proportion of patients who initiated dialysis prior to an SLE diagnosis suggests a profound gap in early detection and specialized care. Furthermore, the substantial geographic displacement, especially in the Northeast region, and the high prevalence of inter-municipal travel for dialysis treatment impact directly a socioeconomic and physical strain on patients. These data underscore the urgent need for improved screening protocols and a more decentralized specialized care network to mitigate the impact of LN on the Brazilian patients.
METHODS: This retrospective study analyzed anonymized claim data of patients from 2023 Outpatient Information System of SUS (SIA-SUS). LN patients were defined by SLE diagnosis (ICD-10 M32) and recorded dialysis, specific immunosuppressant treatment with nephrology care, ≥2 nephrology visits, or renal disease treatment. Patient displacement (distance and time) was estimated by combining SIA-SUS, Brazilian Institute of Geography and Statistics, and OpenStreetMap data using R software.
RESULTS: In 2023, 15,580 LN patients were identified; 1,503 (9.6%) were on dialysis, with 50.9% initiating dialysis before SLE diagnosis, reflecting severe progression. Geolocation analysis of 1,233 patients showed most resided in the Southeast (44.0%) and Northeast (27.4%). Median travel to dialysis was 28.8 km (37 minutes). Distances were longest in the Northeast (38 km, 47 minutes) and shortest in the Southeast (27.2 km, 37 minutes). Notably, 42.0% traveled outside their municipality for dialysis, with the Northeast recording 52.8%. Travel distribution showed 6.6% traveled over 250 km, 14.7% between 100-250 km, 13.7% between 50-100 km, and 65.0% under 50 km.
CONCLUSIONS: This study shows a critical disease burden for LN patients in the SUS, characterized by late nephrological intervention and significant logistical barriers. The critical proportion of patients who initiated dialysis prior to an SLE diagnosis suggests a profound gap in early detection and specialized care. Furthermore, the substantial geographic displacement, especially in the Northeast region, and the high prevalence of inter-municipal travel for dialysis treatment impact directly a socioeconomic and physical strain on patients. These data underscore the urgent need for improved screening protocols and a more decentralized specialized care network to mitigate the impact of LN on the Brazilian patients.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH172
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)