Presentation (CTI)

OBJECTIVES: Systemic lupus erythematosus (SLE) is a high patient-burden chronic, multisystem autoimmune disease. Expansion of treatment options has increased the need for robust economic models to inform decision-making. We reviewed published SLE and lupus nephritis (LN) modelling studies to characterise model approaches to date.
METHODS: Building on a published review of SLE economic modelling studies (6 studies to July 2018), a targeted literature review identified 23 eligible economic modelling publications (2002-2025). Technical model specifications, including population, intervention, comparator, perspective, model type, health states, events, and evidence sources were extracted.
RESULTS: Included studies assessed novel pharmaceutical treatments (14/23) or overall disease burden (8/23), while one study assessed a testing regimen. Fourteen models evaluated SLE or mixed rheumatological/SLE populations, and nine focused on LN. None comprehensively integrated systemic disease and nephritis pathways. The most common model structures were Markov state-transition models (11/23), followed by individual-patient simulation models (5/23). Other approaches (7/23) included decision trees, hybrid models, and budget or cost only models. No studies used discrete-event simulation. Frequently represented states and events included SLE activity or severity, treatment response or remission, flares or exacerbations, renal progression or kidney failure, dialysis, transplantation, and death. Organ damage, corticosteroid exposure, and adverse events were modelled less consistently. Therapeutic appraisals typically used trial-derived efficacy inputs with extrapolation, whereas burden and progression models relied on epidemiological, cost, cohort, or registry-based inputs, where reported.
CONCLUSIONS: Despite growing economic modelling in SLE and LN, no established standard modelling precedent has emerged. Capture of key disease- and treatment-specific features including organ involvement, disease activity, progression, flares, and corticosteroid exposure is important to enable comprehensive economic evaluation.