scholarly journals Healthcare resource utilization and costs associated with long-term corticosteroid exposure in patients with systemic lupus erythematosus

Lupus ◽  
2018 ◽  
Vol 27 (11) ◽  
pp. 1799-1809 ◽  
Author(s):  
S Kabadi ◽  
J Yeaw ◽  
A K Bacani ◽  
E Tafesse ◽  
K Bos ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Resource Utilization ◽  
Lupus Erythematosus ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
High Dose ◽  
Systemic Lupus ◽  
Oral Corticosteroids ◽  
Baseline Characteristics ◽  
Dose Corticosteroid

Objective To evaluate the association between exposure to oral corticosteroids and future healthcare resource utilization and costs for patients with systemic lupus erythematosus. Methods Adults diagnosed with systemic lupus erythematosus (index date) between 1 January 2008 and 30 June 2013 and naive to oral corticosteroids with continuous health plan enrollment for ≥6 months pre- and ≥5 years post-index were identified from a large health plan claims database. Per-patient monthly average daily dose of oral corticosteroids (prednisone or its equivalent) was calculated for the first 2 years post-index to categorize patients into four steroid exposure cohorts: low (≤5 mg/day), medium (6–20 mg/day), high (>20 mg/day) and no steroids. Differences in healthcare resource utilization and total healthcare costs during the third year post-index across corticosteroid exposure cohorts were modeled with adjustment for baseline characteristics. Results The study included 18,618 systemic lupus erythematosus patients (163 high dose, 1127 medium dose, 6717 low dose and 10,611 no steroids). Compared to low-dose corticosteroid users, high-dose corticosteroid users were more likely to have emergency room visits (39.3% vs. 29.7%; p = 0.0085) and to be hospitalized (21.5% vs. 12.3%; p = 0.0005). After adjustment for baseline characteristics, they also had significantly greater average annual total healthcare costs (US$60,366 vs. US$18,777; p < 0.0001). A 1 mg increase in corticosteroid average daily dose was associated with 1.07 times the average annual costs after adjusting for baseline characteristics ( p < 0.0001). Conclusion Long-term high-dose oral corticosteroid use was associated with significantly greater future healthcare resource utilization and costs. Judicious reduction in daily steroid dose may decrease the imminent economic burden associated with high-dose steroid use in systemic lupus erythematosus.

The Use of Micronutrient Supplements Is Not Associated with Better Quality of Life and Disease Activity in Canadian Patients with Systemic Lupus Erythematosus

2009 ◽  
Vol 37 (1) ◽  
pp. 87-90 ◽  
Author(s):  
ELAHEH AGHDASSI ◽  
STACEY MORRISON ◽  
CAROLINA LANDOLT-MARTICORENA ◽  
JIANDONG SU ◽  
CHRISTIAN A. PINEAU ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Resource Utilization ◽  
Lupus Erythematosus ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Systemic Lupus ◽  
Healthcare Resources

Objective.Associations between the use of micronutrient supplements (MS) and disease activity, quality of life (QOL), and healthcare resource utilization were studied in a Canadian population of patients with systemic lupus erythematosus (SLE).Methods.QOL was assessed by the Medical Outcomes Study 36-item Short Form. Healthcare resource utilization and disease activity/damage were determined.Results.Of the 259 subjects studied, 53% were MS users and 34% used only calcium/vitamin D. MS users had a higher Systemic Lupus International Collaborating Clinics score and utilized more healthcare resources. Disease activity and QOL were similar between MS users and nonusers.Conclusion.MS are frequently used by patients with SLE and are not associated with concomitant benefit on QOL. MS users utilized more healthcare resources.

scholarly journals Healthcare Utilization and Costs of Systemic Lupus Erythematosus in Medicaid

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Hong J. Kan ◽  
Xue Song ◽  
Barbara H. Johnson ◽  
Benno Bechtel ◽  
Donna O'Sullivan ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Healthcare Utilization ◽  
Resource Utilization ◽  
Lupus Erythematosus ◽  
Index Date ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Systemic Lupus ◽  
Medicaid Population ◽  
Annual Total

Objective. Healthcare utilization and costs associated with systemic lupus erythematosus (SLE) in a US Medicaid population were examined.Methods. Patients ≥ 18 years old with SLE diagnosis (ICD-9-CM 710.0x) were extracted from a large Medicaid database 2002–2009. Index date was date of the first SLE diagnosis. Patients with and without SLE were matched. All patients had a variable length of followup with a minimum of 12 months. Annualized healthcare utilization and costs associated with SLE and costs of SLE flares were assessed during the followup period. Multivariate regressions were conducted to estimate incremental healthcare utilization and costs associated with SLE.Results. A total of 14,777 SLE patients met the study criteria, and 14,262 were matched to non-SLE patients. SLE patients had significantly higher healthcare utilization per year than their matched controls. The estimated incremental annual cost associated with SLE was $10,984, with the highest increase in inpatient costs (P<0.001). Cost per flare was $11,716 for severe flares, $562 for moderate flares, and $129 for mild flares. Annual total costs for patients with severe flares were $49,754.Conclusions. SLE patients had significantly higher healthcare resource utilization and costs than non-SLE patients. Patients with severe flares had the highest costs.

Myelofibrosis and Systemic Lupus erythematosus: Reversal of Fibrosis with High-Dose Corticosteroid Therapy

1992 ◽  
Vol 88 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Yasushi Inoue ◽  
Atsushi Matsubara ◽  
Shigeru Okuya ◽  
Koichiro Okafuji ◽  
Kohei Kaku ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Corticosteroid Therapy ◽  
Lupus Erythematosus ◽  
High Dose ◽  
Systemic Lupus ◽  
High Dose Corticosteroid ◽  
Dose Corticosteroid

scholarly journals Systemic lupus erythematosus-a good maternal and fetal outcome

2020 ◽  
Vol 9 (12) ◽  
pp. 5176
Author(s):  
Preeti Lewis ◽  
Ashrulina Pal
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Fetal Outcome ◽  
The Body ◽  
High Dose ◽  
Class Iii ◽  
Systemic Lupus ◽  
Chief Complaints ◽  
Significant Impairment ◽  
Dose Corticosteroid

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease which primarily affects women in their reproductive years. The fertility is generally unaffected except in women with active disease, significant impairment of renal function, or high dose corticosteroid or cyclophosphamide therapy, which can result in ovarian dysfunction. This case report elaborates on the course of the pregnancy and the favourable maternal and fetal obstetric outcome of a 28-year-old female with known case of hypothyroidism who presented with chief complaints of generalised swelling all over the body and exertional dyspnoea and was later diagnosed to be a case of focal proliferative lupus nephritis, class III (ISN/RPS) on renal biopsy done postpartum. The effect of pregnancy on maternal disease is controversial. While some studies report exacerbation of SLE during pregnancy,others have not reported increased flares. The only study on this aspect of SLE from our country did not report a flare-up of disease during pregnancy.

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