Study Finds Lupus Treatment Disparities and Need for Uniformity
Researchers reviewed current standard of care or treatment patterns in lupus in France, Germany, Italy, Spain, United Kingdom (EU5) and the US to assess the need for a more efficient and defined treatment pathway.
They asked 263 rheumatologists in the US and EU5 to complete patient record forms for their next five patients. Then they asked their respective five patients to complete a form describing how lupus affected them. Significant differences were observed between US and EU5 in current treatment classes for first and second line of therapy. Globally, 84.4% of people with lupus are receiving glucocorticoids (steroids) and are continuously receiving it, despite the therapy’s high risk. A higher proportion of patients in the EU5 have been on glucocorticoids (GCS) for six months or longer when compared to the US.
“This recent data on real-world clinical rheumatology practice and treatment of SLE patients in Europe and the US reveal alarmingly high rates of glucocorticoid usage and very low rates of biologic usage. Rates of glucocorticoid use were a bit higher in Europe than the US, but in both locations there are likely multiple reasons for the overuse of glucocorticoids, which have so many known adverse side effects, both in the short and long-terms. These reasons include medical insurance restrictions on access to more expensive medications and lack of acute efficacy of other existing SLE therapies,” states study author, Karen H. Costenbader, M.D., M.P.H., Director of the Lupus Program at Brigham and Women’s Hospital in Boston and chair of Lupus Foundation of America’s Medical-Scientific Advisory Council.
Significant differences in treatment approach between regions highlights the need for a better understanding of this disparity and a united approach to lupus treatment. The researchers call for an update to the lupus guidelines and their dissemination with better understanding of risk benefits of GCS vs. immunosuppressive and biologic therapy. Learn about lupus treatment.