0998: A Real-world Analysis Showing Significant Variance in Treatment Patterns Among over 1,000 Systemic Lupus Erythematosus (SLE) Patients in the US

Ryan Rex¹, Vibeke Strand² and Maxine Yarnall¹, ¹Spherix Global Insights, Exton, PA, ²Stanford University School of Medicine, Stanford, CA

Background/Purpose: Systemic lupus erythematosus (SLE) patients present significant challenges in management. This study was to uncover real-world treatment patterns among moderate to severely active SLE patients in the US.

Methods: 1,002 records from SLE patients with moderate and severely active disease were collected in collaboration with 190 US rheumatologists via an online survey platform from March 9 through April 17, 2022. Patients were at least 18 years old with diagnosed SLE and treated with at least one prescription agent.

Results: An unexpectedly high number of treatment combinations were observed among the study sample. Over 80 different treatment regimens were reported, with a higher prevalence of polypharmacy in patients with more severe SLE.

While the leading treatment among audited patients is monotherapy hydroxychloroquine, this only accounts for about one-tenth of all patients and is much more common among those with moderate disease than severe. Monotherapy belimumab is slightly more prevalent among severe patients, yet these patients are typically on a wide variety of agents, frequently incorporating methotrexate (MTX), mycophenolate mofetil (MMF), hydroxychloroquine (HCQ), azathioprine (AZA), and steroids.

Regarding biologic exposure, 28% of audited patients are currently on belimumab, 6% on rituximab, and 3% on recently approved anifrolumab. Nearly one-quarter of the 7% of patients on calcineurin inhibitors (CNI) are on recently approved voclosporin.

Conclusion: SLE treatment regimens are highly varied in the US, with disease severity playing a critical role in the treatment algorithm. Recent approval of Type 1 interferon inhibitor anifrolumab in February 2022 is likely to shift the treatment approach even further as rheumatologists settle on ideal patient types for the new drug.
Current regimen type in moderate and severe SLE.

Current treatment in moderate and severe SLE.
Disclosures: R. Rex, None; V. Strand, AbbVie, Amgen, AstraZeneca, Bayer, Bristol-Myers Squibb(BMS), Boehringer-Ingelheim, Chemocentryx, Celltrion, Genentech/Roche, Gilead, GlaxoSmithKlein(GSK), Inmedix, Janssen, Kiniksa, Merck/MSD, Novartis, Pfizer, Regeneron Pharmaceuticals, Rheos, R-Pharma, Samsung, Sandoz, Sanofi, Scipher, Setpoint, Spherix, Aria, Bioventus, Blackrock, Equilium, Glenmark, Horizon, Kypha, Lilly, MiMedx, Sorrento, Tonix, Priovant; M. Yarnall, None.