Substantial Economic Burden Associated With Lupus Nephritis 

Lupus nephritis is expensive to manage, concludes a systemic literature review published online ahead of print in Rheumatology and Therapy.

“The consensus across the 22 studies was that the economic burden of lupus nephritis is substantial,” researchers wrote, “particularly in active or severe disease, or if there is progression to end-stage kidney disease.”

The 22 studies, published between 2007 and 2019, contained data on costs and health care resource utilization (HCRU) associated with lupus nephritis. Thirteen of the studies were from North America.

According to findings, lupus nephritis is associated with substantially higher direct costs, (including total annual, hospitalization, and end-stage kidney disease-related direct costs), total indirect costs, and HCRU (including hospitalization, outpatient services, and medication use) compared with patients without systemic lupus erythematosus (SLE) or patients with SLE without lupus nephritis. End-stage kidney disease and dialysis were key contributors to costs.

“The need for dialysis significantly increased the cost of treatment (4.1 times) compared with patients with lupus nephritis not requiring dialysis,” researchers wrote, “and end-stage kidney disease was a significant independent contributor to treatment costs.”

No studies addressed the cost of renal flares, however, which researchers characterized as a notable literature gap. While renal flare costs were likely included in other costs reported in studies, specific data would help shed light on the economic benefit of avoiding the medical emergency if possible. Similarly, more data is needed for patients with lupus nephritis and end-stage kidney disease, they noted.

“As new interventions emerge for the treatment of active lupus nephritis, greater delineation of these costs at the patient level will be critical to demonstrating their economic value,” researchers advised.

Reference:
Thompson JC, Mahajan A, Scott DA, Gairy K. The economic burden of lupus nephritis: a systematic literature review [published online ahead of print November 3, 2021]. Rheumatol Ther. doi:10.1007/s40744-021-00368-y