The following is a summary of “Clinical Management of Lupus in the United States: A claims-based analysis,” published in the June 2024 issue of Rheumatology by Kingsmore et al.
To explore the clinical management and diagnostic pathways of patients identified with lupus across various clinical settings in the United States.
This study utilized claims data from EVERSANA databases to analyze diagnoses, procedures, medications, and physician specialties among three distinct lupus cohorts: lupus nephritis (LN), systemic lupus erythematosus excluding LN (SLE), and cutaneous lupus erythematosus excluding SLE and LN (CLE). Patients were identified based on repeated occurrences of lupus-specific ICD codes within a six-month period.
Across the LN, SLE, and CLE cohorts, 28,372, 82,744, and 13,920 patients were identified, respectively. Analysis revealed inconsistencies in diagnostic practices, with clinical features of lupus often lacking, autoantibody testing infrequent, biopsies rare, and subspecialty involvement limited. There was a notable increase in laboratory testing, non-lupus diagnoses, emergency department visits, and healthcare costs in the year preceding the lupus diagnosis, suggesting uncertainty in initial disease recognition. Nevertheless, the repeated use of lupus codes underscored ongoing clinical recognition and management. Variations were observed among the cohorts regarding laboratory testing frequency, subspecialty care utilization, skin and renal biopsies rates, and medication management. The cost of care for patients with lupus also exceeded that of a reference population, both before and after diagnosis.
This study comprehensively assesses lupus care practices across diverse clinical settings in the United States, highlighting discrepancies from recommended guidelines. Despite challenges in diagnostic clarity and adherence to standard protocols, the findings underscore the persistent management efforts for patients diagnosed with lupus in general healthcare settings.
Source: sciencedirect.com/science/article/abs/pii/S0049017224001124
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