Alarcon, GS

Aranow, C

Askanase, A

Bae, S-C

Barber, M

Bernatsky, S

Bruce, IN

Buyon, JP

Chatham, WW

Clarke, AE

Dooley, MA

Farewell, V

Fortin, PR

Ginzler, EM

Gladman, DD

Gordon, C

Hanly, JG

Inanc, M

Isenberg, DA

Jacobsen, S

Kalunian, KC

Kamen, DL

Khamashta, M

Lim, SS

Maddison, P

Manzi, S

Merrill, JT

Nived, O

O'Keeffe, A

Peschken, CA

Petri, M

Rahman, A

Ramos-Casals, M

Ramsey-Goldman, R

Romero-Diaz, J

Ruiz-Irastorza, G

Sanchez-Guerrero, J

St Pierre, Y

Steinsson, K

Stoll, T

Sturfelt, GK

Su, L

Theriault, C

Thompson, K

Urowitz, M

van Vollenhoven, RF

Wallace, DJ

Zoma, A

UCL Discovery

pdfcrowd.comABSTRACT NUMBER: 989Economic Evaluation of Lupus Nephritis in an InternationalInception Cohort: Comparing the Hospitalization,Medication, Dialysis, and Procedure Costs of Those with andwithout NephritisMegan Barber , John G. Hanly , Aidan O'Keeffe , Li Su , Murray Urowitz , Yvan St. Pierre , JuanitaRomero-Diaz , C. Gordon , Sang-Cheol Bae , Sasha Bernatsky , Daniel J Wallace , Joan T.Merrill , David A. Isenberg , Anisur Rahman , Ellen M. Ginzler , Paul R. Fortin , Dafna D.Gladman , Jorge Sanchez-Guerrero , Michelle Petri , Ian N. Bruce , Mary Anne Dooley ,Rosalind Ramsey-Goldman , Cynthia Aranow , Graciela S. Alarcon , W. Winn Chatham ,Kristján Steinsson , Ola Nived , Gunnar K. Sturfelt , Susan Manzi , Munther Khamashta ,Ronald F. van Vollenhoven , Asad Zoma , Manel Ramos-Casals , Guillermo Ruiz-Irastorza , S.Sam Lim , Thomas Stoll , Murat Inanc , Kenneth C. Kalunian , Diane L. Kamen , PeterMaddison , Christine A. Peschken , Søren Jacobsen , Anca Askanase , Jill P. Buyon , ChrisTheriault , Kara Thompson , Vernon Farewell  and Ann E. Clarke , Division of Rheumatology,University of Calgary, Caglary, AB, Canada, Rheumatology, Division of Rheumatology, CapitalHealth and Dalhousie University, Halifax, NS, Canada, Statistical Science, University CollegeLondon, London, United Kingdom, MRC Biostatistics Unit, Institute of Public Health, UniversityForvie Site, Cambridge, UK, Cambridge, United Kingdom, Rheumatology, University of Toronto,Toronto Western Hospital, Toronto, ON, Canada, Rheumatology, U of Toronto, Toronto WesternHospital, Toronto, ON, Canada, Clinical Epidemiology, Research Institute of the McGill UniversityHealth Centre, Montreal, QC, Canada, Immunology and Rheumatology, Instituto Nacional deCiencias Medicas y Nutrición, Mexico City, Mexico, School of Immunity and Infection, College ofMedical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom,Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea,Rheum/Clin. Epid., McGill MUHC/RVH, Montreal, QC, Canada, Cedars-Sinai Medical Center,West Hollywood, CA, Clinical Pharmacology, Oklahoma Medical Research Foundation, OklahomaCity, OK, Rayne Institute, Centre for Rheumatology Research, UCL Division of Medicine, London,United Kingdom, Centre for Rheumatology Research,Rayne Institute, 4th Floor, University CollegeLondon, London, United Kingdom, Medicine/Box 42, SUNY-Downstate, Brooklyn, NY,Rheumatology, University of Laval, Quebec, QC, Canada, Department of Medicine, Division ofRheumatology, University of Toronto, Toronto, ON, Canada, Rheumatology, Toronto WesternHospital, Toronto, ON, Canada, Division of Rheumatology, Johns Hopkins University, Baltimore,MD, Stopford Building, Arthritis Research UK Centre for Epidemiology, Centre forMusculoskeletal Research, Institute of Inflammation and Repair, Manchester Academic HealthScience Centre, The University of Manchester, Manchester, United Kingdom, UNC Kidney Centre,Chapel Hill, NC, Northwestern University Feinberg School of Medicine, Chicago, IL, FeinsteinInstitute for Medical Research, Mahasset, NY, Medicine, University of Alabama at Birmingham,Birmingham, AL, Medicine/Clinical Immunology and Rheumatology, University of Alabama atBirmingham, Birmingham, AL, Centre for Rheumatology Research, Landspital University Hospital,Reykjavik, Iceland, Rheumatology, Inst of Clinical sciences, Lund, Sweden, Department ofRheumatology, Univ Hospital Lund, Lund, Sweden, Division of Rheumatology, University ofPittsburgh School of Medicine, Pittsburgh, PA, Graham Hughes Lupus Research Laboratory, TheRayne Institute, St Thomas' Hospital, London, United Kingdom, Department of Medicine, Unit forClinical Therapy Research, Inflammatory Diseases (ClinTRID), The Karolinska Institute, Stockholm,1 2 3 4 5,6 78 9 10 11 1213 14 15 16 1718 19 20 21 2223 24 25 2627 28 29 30 3132 33 34 3536 37 38 39 4041 42 43 44 4546 46 47 48 1234567891011 121314151617 181920212223 2425262728 2930313233pdfcrowd.comDate: Sunday, November 8, 2015Session Title: Systemic LupusErythematosus - Clinical Aspects andTreatment I: Epidemiology and PrognosisSession Type: ACR Concurrent AbstractSessionSession Time: 2:30PM-4:00PMClinical Therapy Research, Inflammatory Diseases (ClinTRID), The Karolinska Institute, Stockholm,Sweden, Lanarkshire Centre for Rheumatology, Hairmyres Hospital, East Kilbride, UnitedKingdom, Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Sjögren SyndromeResearch Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, Institut d’InvestigacionsBiomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain, Autoimmune Disease Research Unit,Service of Internal Medicine, Hospital de Cruces, UPV/EHU, Barakaldo, Spain, Emory UniversitySchool of Medicine, Atlanta, GA, Abteilung Rheumatologie/Rehab, Kantonsspital Schaffhausen,Schaffhausen, Switzerland, Department of Internal Medicine, Division of Rheumatology, IstanbulUniversity, Istanbul Faculty of Medicine, Istanbul, Turkey, Division of Rheumatology, Allergy &Immunology, UCSD School of Medicine Center for Innovative Therapy, La Jolla, CA, Medicine,Medical University of South Carolina, Charleston, SC, Musculoskeletal Medicine, BangorUniversity, Bangor, United Kingdom, Rheumatology, Univ of Manitoba, Winnipeg, MB, Canada,Department of Rheumatology,, Copenhagen University Hospital, Rigshospitalet, Copenhagen,Denmark, Columbia University College of Physicians & Surgeons, New York, NY, Medicine,Division of Rheumatology, New York University School of Medicine, New York, NY, Medicine,Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, NS, Canada,Medicine, Division of Rheumatology, Capital Health and Dalhousie University, Halifax, NS,Canada, Division of Rheumatology, University of Calgary, Calgary, AB, CanadaMeeting: 2015 ACR/ARHP Annual MeetingDate of first publication: September 29, 2015Keywords: Economics, Health care cost, lupus nephritis and outcomesSESSION INFORMATIONBackground/Purpose:Little is known about the long-term costs of lupus nephritis (LN). The annual and long-termhealthcare costs were compared between SLE patients with and without LN.Methods:Patients from 32 centres in 11 countries were enrolled in the Systemic Lupus InternationalCollaborating Clinics (SLICC) inception cohort within 15 months of diagnosis and provided annualdata on renal function, hospitalizations, dialysis, and utilization of medications and selectedprocedures.  LN was diagnosed by renal biopsy or fulfillment of the American College ofRheumatology (ACR) SLE classification criteria renal item.  Renal function was also assessedannually based on estimated glomerular filtration rate (eGFR) or proteinuria (ePrU).  Annualhealth resource utilization was costed using 2012 Canadian prices.  Annual costs associated withrenal function states were obtained from multiple regressions adjusting for age, race/ethnicity,disease duration, SLICC centre location, SLEDAI-2K and SLICC/ACR Damage Index (excluding renalcomponents), and the SF-36.  5-year cumulative costs were estimated by determining annual costsassociated with each renal function state and then forecasting the expected duration in eachstate. Durations were estimated using a relative risk regression model.Results:333435363738394041424344 45464748pdfcrowd.com1645 patients participated, 89.2% females, 48.8% Caucasian, mean age at diagnosis 34.8 years (SD13.4), mean disease duration at enrollment 0.5 years (SD 0.3), and mean follow up 6.1 years (SD3.3).  LN was diagnosed in 39.4% over follow up.  Health resource utilization and annual costs(after adjustment using regression) were markedly higher in those with an eGFR < 30 ml/min orwith LN (Table 1). Table 1.  Predicted Annual Health Costs Stratified by State of Renal FunctioneGFR ePrU Lupus NephritisState Costs, Mean95% CI2012 CDN$State Costs, Mean95% CI2012 CDN$State Costs, Mean95% CI2012 CDN$eGFR >60 ml/min 2234(1503, 2965)ePrU< 0.25g/d 2247(1406, 3088)No LupusNephritis1588(726,2450)eGFR 30-60ml/min 3014(1636, 4392)ePrU 0.25-3.0g/d 3424(2287, 4561) LupusNephritis3876(2949,4803)eGFR < 30 ml/min 12551(10301, 14801)ePrU > 3.0 g/d 4703(2128, 7278)  5-year cumulative costs stratified by baseline renal function state were calculated by multiplyingthe annual costs associated with each state by the expected duration in that state (eGFR examplein Table 2). Table 2. Expected Duration in Each Renal State over 5 Years Expected Duration in each State over 5 yearsBaseline State Annual Costs2012 CDN$eGFR >60 ml/mineGFR 30-60ml/mineGFR < 30ml/mineGFR >60 ml/ min 2234 4.74 yrs 0.22 yrs 0.04 yrspdfcrowd.comeGFR 30-60 ml/min 3014 2.60 yrs 1.88 yrs 0.52 yrseGFR < 30 ml/min 12551 1.03 yrs 1.09 yrs 2.88 yrsFive year cumulative costs were greater in those with severely impaired eGFR or with LN atbaseline (Table 3). Table 3. Predicted 5-Year Cumulative Health Costs Stratified by Baseline State of Renal FunctioneGFR ePrU Lupus NephritisBaseline State Costs, Mean95% CI2012 CDN$Baseline State Costs, Mean95% CI2012 CDN$BaselineStateCosts, Mean95% CI2012 CDN$eGFR >60 ml/ min 11763(7904,15622)ePrU< 0.25 g/d 12070(7594,16547)NoLupusNephritis8663(4331, 12995)eGFR 30-60ml/min 18008(12348,23667)ePrU 0.25-3.0g/d 13834(8758,18909)LupusNephritis19380(14745, 24015)eGFR < 30 ml/min 41732(32998,50467)ePrU > 3.0 g/d 15627(9192,22061)   Conclusion:Patients with an eGFR <30ml/min and LN incur higher annual and 5-year cumulative costs.  Byestimating the expected duration in each renal function state and incorporating associatedannual costs, disease severity at presentation can be used to anticipate future healthcare costs,critical knowledge for cost effectiveness evaluations of novel LN therapies.Disclosure: M. Barber, Bristol-Myers Squibb, 2; J. G. Hanly, Bristol-Myers Squibb, 2; A. O'Keeffe,Bristol-Myers Squibb, 2; L. Su, Bristol-Myers Squibb, 2; M. Urowitz, Bristol-Myers Squibb, 2; Y. St.pdfcrowd.comBristol-Myers Squibb, 2; L. Su, Bristol-Myers Squibb, 2; M. Urowitz, Bristol-Myers Squibb, 2; Y. St.Pierre, Bristol-Myers Squibb, 2; J. Romero-Diaz, Bristol-Myers Squibb, 2; C. Gordon, Bristol-MyersSquibb, 2; S. C. Bae, Bristol-Myers Squibb, 2; S. Bernatsky, Bristol-Myers Squibb, 2; D. J. Wallace,Bristol-Myers Squibb, 2; J. T. Merrill, Bristol-Myers Squibb, 2; D. A. Isenberg, Bristol-Myers Squibb,2; A. Rahman, Bristol-Myers Squibb, 2; E. M. Ginzler, Bristol-Myers Squibb, 2; P. R. Fortin, Bristol-Myers Squibb, 2; D. D. Gladman, Bristol-Myers Squibb, 2; J. Sanchez-Guerrero, Bristol-MyersSquibb, 2; M. Petri, Bristol-Myers Squibb, 2; I. N. Bruce, Bristol-Myers Squibb, 2; M. A. Dooley,BriThe SLICC research network received funding for this study from Bristol-Myers Squibb, 2; R.Ramsey-Goldman, Bristol-Myers Squibb, 2; C. Aranow, Bristol-Myers Squibb, 2; G. S. Alarcon,Bristol-Myers Squibb, 2; W. W. Chatham, Bristol-Myers Squibb, 2; K. Steinsson, Bristol-MyersSquibb, 2; O. Nived, Bristol-Myers Squibb, 2; G. K. Sturfelt, Bristol-Myers Squibb, 2; S. Manzi,Bristol-Myers Squibb, 2,Bristol-Myers Squibb, 2; M. Khamashta, Bristol-Myers Squibb, 2; R. F. vanVollenhoven, Bristol-Myers Squibb, 2; A. Zoma, Bristol-Myers Squibb, 2; M. Ramos-Casals, Bristol-Myers Squibb, 2; G. Ruiz-Irastorza, Bristol-Myers Squibb, 2; S. S. Lim, Bristol-Myers Squibb, 2; T.Stoll, Bristol-Myers Squibb, 2; M. Inanc, Bristol-Myers Squibb, 2; K. C. Kalunian, Bristol-MyersSquibb, 2; D. L. Kamen, Bristol-Myers Squibb, 2; P. Maddison, Bristol-Myers Squibb, 2; C. A.Peschken, Bristol-Myers Squibb, 2; S. Jacobsen, Bristol-Myers Squibb, 2; A. Askanase, Bristol-Myers Squibb, 2; J. P. Buyon, Bristol-Myers Squibb, 2; C. Theriault, Bristol-Myers Squibb, 2; K.Thompson, Bristol-Myers Squibb, 2; V. Farewell, Bristol-Myers Squibb, 2; A. E. Clarke, Bristol-Myers Squibb, 2.To cite this abstract in AMA style:Barber M, Hanly JG, O'Keeffe A, Su L, Urowitz M, St. Pierre Y, Romero-Diaz J, Gordon C, Bae SC,Bernatsky S, Wallace DJ, Merrill JT, Isenberg DA, Rahman A, Ginzler EM, Fortin PR, Gladman DD,Sanchez-Guerrero J, Petri M, Bruce IN, Dooley MA, Ramsey-Goldman R, Aranow C, Alarcon GS,Chatham WW, Steinsson K, Nived O, Sturfelt GK, Manzi S, Khamashta M, van Vollenhoven RF,Zoma A, Ramos-Casals M, Ruiz-Irastorza G, Lim SS, Stoll T, Inanc M, Kalunian KC, Kamen DL,Maddison P, Peschken CA, Jacobsen S, Askanase A, Buyon JP, Theriault C, Thompson K,Farewell V, Clarke AE. Economic Evaluation of Lupus Nephritis in an International InceptionCohort: Comparing the Hospitalization, Medication, Dialysis, and Procedure Costs of Thosewith and without Nephritis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10).http://acrabstracts.org/abstract/economic-evaluation-of-lupus-nephritis-in-an-international-inception-cohort-comparing-the-hospitalization-medication-dialysis-and-procedure-costs-of-those-with-and-without-nephritis/. Accessed January 17, 2017.ACR Meeting Abstracts - http://acrabstracts.org/abstract/economic-evaluation-of-lupus-nephritis-in-an-international-inception-cohort-comparing-the-hospitalization-medication-dialysis-and-procedure-costs-of-those-with-and-without-nephritis/

Economic Evaluation of Lupus Nephritis in an International Inception Cohort: Comparing the Hospitalization, Medication, Dialysis, and Procedure Costs of Those with and without Nephritis

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Economic Evaluation of Lupus Nephritis in an International Inception Cohort: Comparing the Hospitalization, Medication, Dialysis, and Procedure Costs of Those with and without Nephritis

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