Increasing Use of Biologics in Treatment of Systemic Lupus Erythematosus Patients: Real-World Observations from American Rheumatology Network-Trio Health Rheumatology Registry


Helfgott SM1, Rane D2, Huston K3, Broestl JE2, Singh JA4, Soloman N5, Edgerton C6
1Brigham and Women's Hospital, Boston, MA, USA, 2Trio Health, Louisville, CO, USA, 3The Center for Rheumatic Disease & Allergy-Immunology, Kansas City, MO, USA, 4University of Alabama at Birmingham, Birmingham, AL, USA, 5Arizona Arthritis, Phoenix, AZ, USA, 6Articularis Healthcare, Summerville, SC, USA

Presentation Documents


Systemic lupus erythematosus (SLE) treatments include steroids, antimalarials, immunosuppressants and/or biologics. We examine treatment choices in the last three years within community rheumatology practices to understand current use of biologics, persistence to belimumab, the most commonly used biologics for SLE, and association with different treatment and patient characteristics.


The ARN-TRIO Health Rheumatology registry contains EMR, medical claims, and prescription data generated in care of >100,000 patients by ARN, a network of independent practices. Inclusion criteria: Adult (18+) patients with SLE who initiated or switched to a new treatment from Jan 2017-May 2020. Statistical analysis used t-test (continuous variables) and chi-square/Fischer’s exact tests (categorical variables). Time to events analyses were conducted by Kaplan-Meier and subsequent log-rank test.


Study population (n= 5,797): 10,913 distinct treatments at start. Start percentages by drug class, 2017-2019 indicated annualized growth rates of 20%, 7%, 2%, -2% for biologics, immunosuppressants, steroids, and antimalarials respectively, with significant differences (p<0.050) for all drug classes except steroids. Patients were classified into biologics/non-biologics group by initial treatment and compared. Biologic therapies were mostly belimumab (66%, 347/525); rituximab (11%, 60/525). Compared to the non-biologics, the biologics group differed in use of other drug classes and payer, but not in age, gender, or race. Mean time to belimumab discontinuation was 838 days (25th percentile = 620 days, median not reached). Time to belimumab discontinuation differed by concomitant use of other drug classes and was not associated with age, gender, race, or payer.


The use of biologics for SLE has increased considerably since 2017. For patients that received belimumab, persistence on therapy was substantial and increased in populations receiving concomitant steroids, antimalarials, or immunosuppressants.

Conference/Value in Health Info

2021-05, ISPOR 2021, Montreal, Canada

Value in Health, Volume 24, Issue 5, S1 (May 2021)




Clinical Outcomes, Health Service Delivery & Process of Care, Patient-Centered Research

Topic Subcategory

Adherence, Persistence, & Compliance, Clinical Outcomes Assessment, Disease Management, Treatment Patterns and Guidelines


Musculoskeletal Disorders, Systemic Disorders/Conditions

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