scholarly journals Pharmacoeconomic analysis of using belimumab for the treatment of systemic lupus erythematosus

2018 ◽  
Vol 11 (3) ◽  
pp. 23-37
Author(s):  
A. G. Tolkushin ◽  
N. L. Pogudina
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Standard Therapy ◽  
Early Stage ◽  
Therapy Group ◽  
Pharmacoeconomic Analysis ◽  
Indirect Costs ◽  
Systemic Lupus ◽  
Standard Therapy Group ◽  
Permanent Disability

The aim is to study the clinical and economic aspects of using belimumab for the treatment of systemic lupus erythematosus (SLe) in patients with high SLe activity, the presence of anti-DNA, a low level of complement in the blood plasma and minimal lupus organ damage at the early stage.Materials and methods. The Markov model of SLe is used. The initial probabilities of the Markov transitions are obtained from analysis of published clinical and observational studies. The prices of the relevant drugs were obtained from the VeD price registry. Medical and nonmedical expenses are calculated on the basis of the current standards for financial costs and coefficients, as well as payments for temporary and permanent disability. Indirect costs are calculated using the method of human capital.Results. It has been found that using belimumab leads to a decrease in costs (both direct and indirect), as well as an increase in patient survival. The total costs for belimumab vs standard therapy approximated 8.84 million rubles vs 17.72 million rubles (of which 4.05 million rubles vs 5.58 million rubles were direct costs, and 2.57 million rubles vs 2.88 million rubles were indirect medical costs) on average per patient in the belimumab group vs standard therapy group, respectively.Conclusion. The use of belimumab in the target population of patients is pharmacoeconomically justified and expedient because it leads to increased treatment efficiency and reduction of direct and indirect costs. 

scholarly journals The current status of the problem with systemic lupus erythematosus in Kazakhstan

2020 ◽  
Vol 14 (1) ◽  
pp. 32-39
Author(s):  
B. G. Isayeva ◽  
M. M. Saparbayeva ◽  
S. M. Isayeva ◽  
M. M. Kulshymanova ◽  
Sh. M. Kaiyrgali ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Early Stage ◽  
Current Status ◽  
Treatment Programs ◽  
Systemic Lupus ◽  
Basic Principles ◽  
Inpatient Settings ◽  
The Republic

Objective: to analyze the provision of medical, including rheumatology, care in Kazakhstan, to study the incidence of systemic lupus erythematosus (SLE), and to develop a registry of patients with this condition.Material and methods. The investigators analyzed the guidelines for the organization of medical, including rheumatology, care in the republic and the official statistical materials of the Ministry of Health of the Republic of Kazakhstan in the period 2012 to 2017. Articles were searched to select activity indices, organ damages and to assess the quality of life and treatment programs in order to create a registry of patients with SLE.Results and discussion. The paper presents the basic principles of providing medical, including rheumatology, care in the republic. It gives data on the issues of providing SLE patients with medicines in outpatient and inpatient settings. It also analyzes trends in the incidence of SLE in the population of Kazakhstan in 2012 to 2017. There were 4,448 SLE patients, including 3,986 women; a comparative analysis of indicators demonstrated a 62.8% increase in the incidence of SLE from 2012 to 2017. The purpose and objectives of the registry of patients with SLE were substantiated.Conclusion. An analysis of morbidity rates suggests that SLE remains to be significant in the republic. The incidence of SLE has been noted to increase in the period from 2012 to 2017; there is a female preponderance (89.6%). The application of the SLE registry in clinical practice will be able to improve the diagnosis of the disease in the early stage and to prevent possible complications. 

Belimumab restores Treg/Th17 balance in patients with refractory systemic lupus erythematosus

Lupus ◽  
2018 ◽  
Vol 27 (12) ◽  
pp. 1926-1935 ◽  
Author(s):  
M Prete ◽  
P Leone ◽  
M A Frassanito ◽  
V Desantis ◽  
C Marasco ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
T Cells ◽  
Lupus Erythematosus ◽  
Standard Therapy ◽  
B Lymphocyte ◽  
Specific Inhibitor ◽  
The United States ◽  
Systemic Lupus ◽  
The Mean

Belimumab, a specific inhibitor of the soluble B lymphocyte stimulator (BlyS), is the first biological drug approved by the United States Food and Drug Administration for the treatment of patients with active systemic lupus erythematosus (SLE) refractory to standard therapy. Given that an imbalance between regulatory T cells (Treg) and interleukin (IL)-17A-secreting T cells (Th17) has been reported in various autoimmune disorders, we assessed the frequency of both Treg and Th17 peripheral blood populations before and after belimumab administration in 20 patients with active SLE refractory to standard therapy. After six months of treatment, the mean SELENA-SLEDAI score as well as the mean anti-double-stranded DNA antibody titers were significantly decreased. In addition, we observed a significant increase in Treg percentages and a parallel, significant decrease in Th17 percentages, accompanied by significantly reduced serum levels of IL-21. In vitro studies showed that Treg purified from belimumab-treated patients were fully functional and displayed a suppressor function similar to that of Treg purified from healthy donors. Belimumab can restore Treg/Th17 balance in SLE patients with uncontrolled disease activity, and this results in decreased flare rate and reduced glucocorticoid dosage.

Hospitalization of patients with systemic lupus erythematosus is a major cause of direct and indirect healthcare costs

Lupus ◽  
2016 ◽  
Vol 26 (7) ◽  
pp. 756-761 ◽  
Author(s):  
A P Anandarajah ◽  
M Luc ◽  
C T Ritchlin
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Length Of Stay ◽  
Lupus Erythematosus ◽  
Annual Cost ◽  
Financial Analysis ◽  
Financial Burden ◽  
Indirect Costs ◽  
Memorial Hospital ◽  
Systemic Lupus ◽  
Direct And Indirect Costs

Objectives The objective of this study was to calculate the direct and indirect costs of admission for systemic lupus erythematosus (SLE) patients, identify the population at risk and investigate potential reasons for admission. Methods We conducted a financial analysis of all admissions for SLE to Strong Memorial Hospital between 1 July 2013 and 30 June 2015. Patient and financial records for admissions with a SLE diagnosis for the above period were retrieved. The total cost of admissions was used as a measure of direct costs and the length of stay used to assess indirect costs. Additionally, we analyzed the demographics of the hospitalized population. Results The average, annual cost of confirmed admissions to Strong Memorial Hospital for SLE was US$3.9–6.4 m. The mean annual cost per patient for hospitalization was US$51,808.41. The length of stay for all SLE patients was 1564–2507 days with an average of 8.5 days per admission. The majority of patients admitted were young women from the city of Rochester. Infections were the most common reason for admissions. Conclusion We demonstrated that admissions are a source of high direct and indirect costs to the hospital and a significant financial burden to the patient. Implementing measures to improve the quality of care for SLE patients will help decrease the morbidity and lower the economic costs to hospitals.

scholarly journals Forecasting index of unfavorable outcomes of systemic lupus erythematosus

2021 ◽  
Vol 15 (3) ◽  
pp. 98-102
Author(s):  
E. A. Aseeva ◽  
N. Yu. Nikishina ◽  
A. A. Mesnyankina ◽  
S. K. Solovyev ◽  
B. Sh. Isaeva ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Early Stage ◽  
Frailty Index ◽  
Organ Damage ◽  
Vulnerability Index ◽  
Systemic Lupus ◽  
Risk Of Death ◽  
The Cost ◽  
International Experts

The development of irreversible organ damage (IOD) in systemic lupus erythematosus (SLE) significantly increases the risk of death, worsens the quality of life and significantly increases the cost of treatment. The development and implementation of specific tools that will promote early identification of the risk of unfavorable outcomes is a priority. The article presents literature review on a new method for prediction of unfavorable outcomes in SLE – frailty index (FI, vulnerability index). FI, developed by a group of international experts on the basis of the database of the international cohort of SLE patients – SLICC (Systemic Lupus International Collaborating Clinics) – is easily reproducible in real clinical practice and can be used in patients with an early stage of SLE to predict the risk of death, the development of IOD. and hospitalization. The SLE Forecasting index of unfavorable outcomes (SLICC-FI) appears to be a promising clinical and research tool for identifying those who need more careful monitoring and an individual therapeutic strategy at an early stage of the disease.

scholarly journals Modern clinical and epidemiological characteristic of systemic lupus erythematosus based on the data of the territorial registry

2017 ◽  
Vol 95 (2) ◽  
pp. 140-147
Author(s):  
Denis V. Shaduro ◽  
V. A. Beloglazov ◽  
A. V. Petrov ◽  
K. A. Aliev
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Early Stage ◽  
Epidemiological Data ◽  
Ethnic Composition ◽  
Systemic Lupus ◽  
American College Of Rheumatology ◽  
Absolute Growth ◽  
The Difference ◽  
Epidemiological Characteristics

Systemic lupus erythematosus (SLE) is a severe rheumatic disease characterized by polysymptomatic clinical picture. At the present stage, there are no updated epidemiological data due to the low prevalence of the disease. The aim of the study was to examine the current clinical and epidemiological characteristics of patients with systemic lupus erythematosus based on the information contained in the territorial register, analysis of occurrence and symptoms at the early stage of the disease. This study demonstrated the epidemiological and clinical characteristics of SLE from the analysis of 107 cases during the period from 2011 to 2013 and retrospective analysis of the cases for 1980-2013. The epidemiological situation was evaluated based on extensive and intensive indicators using statistical software license. The current SLE prevalence was estimated at 5,59 per 100 000 population in 2013, the incidence between 1994 and 2003 at 0,29 per 100 000 population and between 2004 and 2013 at 0,49, with the peak in 2010 up to 1,35 per 100 000 population. The average absolute growth and growth rate of SLE in the first decade was 0,05% and 0,24%, in the second decade 0,001% and 0,006% respectively, with the female to male ratio being 9:1, mean age of the patients 37,62±11,65 years), and ethnic composition of 87 Slavs and 15 Crimean Tatars. The most common symptoms at the early (polyarthritis, fever, dermatitis) and advanced (polyarthritis, Raynaud's syndrome, carditis, myalgia) stages differed from those specified by American College of Rheumatology (1997). The difference between early and late symptoms of SLE was documented . Based on the data obtained, the division of the disease into clinical subtypes (phenotypes) is proposed.

scholarly journals Hematological manifestations of systemic lupus erythematosus in the early stage: association with other symptoms of the disease and possible prognostic value

2019 ◽  
Vol 57 (2) ◽  
pp. 166-170
Author(s):  
A. V. Petrov ◽  
V. A. Beloglazov ◽  
D. V. Shadyro ◽  
A. R. Gafarova ◽  
A. A. Petrov
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Central Nervous System ◽  
Nervous System ◽  
Lupus Erythematosus ◽  
Cumulative Incidence ◽  
Early Stage ◽  
Damage Index ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
Hematological Manifestations

Objective: to assess the relationship between hematological manifestations of systemic lupus erythematosus (SLE) in the early stage of the disease and development of other syndromes and symptoms of the disease, as well as the nature and severity of internal organs damage during the subsequent five-year period.Subjects and methods. The analysis of data of examination of 89 patients with SLE during the five-year period was carried out. The frequency of clinical manifestations of SLE, the level of antinuclear and antiphospholipid antibodies, SLICC/ACR damage index (SDI) depending on the presence of hematological manifestations of SLE in the onset of the disease including leukopenia (LP), thrombocytopenia (TP) and autoimmune hemolytic anemia (AGA) were studied.Results and discussion. In the onset of SLE LP was observed in 21.3%, TP – in 26.9%, AGA – in 8.9% of patients. The presence of LP was associated with an increase of antibodies to SSA frequency, and TP – with more frequent detection of antibodies to Ro-52, cardiolipin and β-2-glycoprotein (p<0.05). Patients with TP in the onset of SLE compared with patients without hematological manifestations, had an increase (p<0.05) of the cumulative incidence of nephritis (83.3 and 42.9%), central nervous system lesions (70.8 and 26.5%), vasculitis (45.8 and 10.2%) and Libman-Sachs endocarditis (20.8 and 6.1%, respectively), which was accompanied by an increase of SDI values (median was 2.09 [2, 1.82; 2.21] and 1.12 [0.81; 1.32], p<0.05). In patients with LP, the cumulative incidence of pneumonitis and Sjogren's syndrome was increased in the onset of SLE compared with patients without hematological manifestations (15.8 vs 6.1% and 15.7 vs 2.0%, respectively, p<0.05).Conclusion. Presence of TP in the onset of SLE is a predictor of kidneys, central nervous system, peripheral vessels and heart valves damage during the next 5 years.

scholarly journals Early prediction of systemic lupus erythematosus using hybrid K-Means J48 decision tree algorithm

2017 ◽  
Vol 7 (1.3) ◽  
pp. 28
Author(s):  
S. Gomathi ◽  
V. Narayani
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Decision Tree ◽  
Lupus Erythematosus ◽  
Clustering Algorithm ◽  
Early Stage ◽  
Early Prediction ◽  
Decision Tree Algorithm ◽  
Systemic Lupus ◽  
Tree Algorithm ◽  
J48 Decision Tree

The objective of the paper is to propose an enhanced algorithm for the prediction of chronic, autoimmune disease called Systemic Lupus Erythematosus (SLE). The Hybrid K-means J48 Decision Tree algorithm (HKMJDT) has been proposed for the effective and early prediction of the SLE. The reason for combining both the clustering and classification algorithms is to obtain the best accuracy and to predict the disease in the early stage. The performance of algorithms such as Naïve Bayes, decision tree, random forest, J48 and Hoeffding tree has been combined with K-means clustering algorithm and compared in an effort to find the best algorithm for diagnosing SLE disease. The results of the statistical evaluation with the comparative study show that the effectiveness of different classification techniques depends on the nature and intricacy of the dataset used. K-means combined with J48 algorithm shows the best accuracy rate of 82.14% on the pre-processed data. The work-flow has been proposed to show the execution of the algorithm.

scholarly journals Safety and Efficacy of Belimumab Plus Standard Therapy for Up to Thirteen Years in Patients With Systemic Lupus Erythematosus

2019 ◽  
Vol 71 (7) ◽  
pp. 1125-1134 ◽  
Author(s):  
Daniel J. Wallace ◽  
Ellen M. Ginzler ◽  
Joan T. Merrill ◽  
Richard A. Furie ◽  
William Stohl ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Standard Therapy ◽  
Systemic Lupus ◽  
Safety And Efficacy
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