OBJECTIVES: To evaluate costs, healthcare resource utilization (HRU), and oral corticosteroid (OCS)-related adverse events (AEs) associated with OCS use >5 mg/day among patients with systemic lupus erythematosus (SLE) who are long-term OCS users (≥12 months’ continuous use) versus nonusers.

METHODS: This retrospective study (GSK Study 214101) used data from the IQVIA Real-World Data Adjudicated Claims Database in the USA. OCS users had ≥1 OCS claim between 2006 and 2019; index date: first OCS claim after 12 months of continuous OCS use (no supply gaps >30 days). Nonusers had no OCS claims during the study period and their index date was imputed based on distribution of time between start of insurance coverage and index for OCS users. Inclusion criteria: ≥5 years of age at index, ≥1 inpatient or ≥2 outpatient SLE claims pre-index, continuous medical/pharmacy coverage in the 12-months pre-index and 24-months post-index. Adjusted regression models were used to assess differences in cost, HRU, and OCS-related AEs during the 24-month observation period in OCS users with 0, 1–2, or 3–4 6-month periods of >5 mg/day versus nonusers.

RESULTS: The study included 6234 OCS users (1587 [25.5%] with 0 periods of >5 mg/day, 2087 [33.5%] with 1–2 periods, 2560 [41.1%] with 3–4 periods) and 7828 OCS nonusers. Comparing OCS users with nonusers with 0, 1–2, and 3–4 periods of >5 mg/day, respectively, adjusted cost differences (95% confidence interval [CI]) were $7774 ($5426─$10,223), $21,738 ($18,898─$25,321), and $30,119 ($26,492─$33,774); incidence rate ratios (95% CI) of all-cause HRU visits were 1.21 (1.14─1.28), 1.40 (1.32─1.47), and 1.57 (1.48─1.66); OCS-related AE odds ratios (95% CI) were 2.03 (1.55─2.66), 2.10 (1.58─2.80), and 3.04 (2.15─4.29); all p<0.01.

CONCLUSIONS: Long-term OCS use >5 mg/day is associated with significantly higher economic burden and risk of OCS-related AEs than nonuse in patients with SLE.

Funding: GSK.