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-  2019 

Real

DOI: 10.1177/0961203319856088

Keywords: Systemic lupus erythematosus,electronic health records,antimalarials,lupus nephritis

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Abstract:

Antimalarials (AMs) reduce disease activity and improve survival in patients with systemic lupus erythematosus (SLE), but studies have reported low AM prescribing frequencies. Using a real-world electronic health record cohort, we examined if patient or provider characteristics impacted AM prescribing. We identified 977 SLE cases, 94% of whom were ever prescribed an AM. Older patients and patients with SLE nephritis were less likely to be on AMs. Current age (odds ratio?=?0.97, p?<?0.01) and nephritis (odds ratio?=?0.16, p?<?0.01) were both significantly associated with ever AM use after adjustment for sex and race. Of the 244 SLE nephritis cases, only 63% were currently on AMs. SLE nephritis subjects who were currently prescribed AMs were more likely to be followed by a rheumatologist than a nephrologist and less likely to have undergone dialysis or renal transplant (both p?<?0.001). Non-current versus current SLE nephritis AM users had higher serum creatinine (p?<?0.001), higher urine protein (p?=?0.05), and lower hemoglobin levels (p?<?0.01). As AMs reduce disease damage and improve survival in patients with SLE, our results demonstrate an opportunity to target future efforts to improve prescribing rates among multi-specialty providers

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