Drug utilization and therapy provision patterns by prescriber types among patients with systemic lupus erythematosus in Korea

Figures & data

Table 1 Demographic features of patients with SLE

Characteristics	n	%
Overall	2,074	100.0
Male (n=526)
≤20 years	40	7.6
21–40 years	140	26.6
41–60 years	205	39.0
≥61 years	141	26.8
Female (n=1,548)
≤20 years	76	4.9
21–40 years	417	26.9
41–60 years	720	46.5
≥61 years	335	21.6
Prescriber specialty
Internal medicine	1,511	72.9
Dermatology	404	19.5
Others	1,142	55.1
Insurance type
National health insurance	1,959	94.5
Medical aid	111	5.4
Patriots & veterans insurance	4	0.2
Level of institution
Tertiary hospital	328	15.8
General hospital	340	16.4
Hospital	123	5.9
Long-term care hospital	15	0.7
Office-based physician practice	1,268	61.1
Region of institution
Seoul, Gyeonggi	1,097	52.9
Gangwon	39	1.9
Chungcheong	277	13.4
Gyeongsang	436	21.0
Jeolla	200	9.6
Jeju	25	1.2
SLE manifestations
Oral ulcer	174	8.4
Arthritis	1,348	65.0
Renal disorders	472	22.8
Seizure	94	4.5
Psychosis	30	1.4

Abbreviation: SLE, systemic lupus erythematosus.

Table 2 Patterns of drug use in patients with SLE

Drug class	n	%
Monotherapy
NSAIDs	217	10.5
Antimalarials	254	12.2
Corticosteroids	184	8.9
Immunosuppressants	31	1.5
Combination therapy
NSAIDs + antimalarials	68	3.3
NSAIDs + corticosteroids	54	2.6
NSAIDs + immunosuppressants	4	0.2
Antimalarials + corticosteroids	275	13.3
Antimalarials immunosuppressants	27	1.3
Corticosteroids + immunosuppressants	56	2.7
Substance switch
NSAIDs	1,287	62.1
Antimalarials	0	0.0
Corticosteroids	518	25.0
Immunosuppressants	49	2.4
Discontinuation
NSAIDs	878	42.3
Antimalarials	120	5.8
Corticosteroids	648	31.2
Immunosuppressants	68	3.3

Note: All were systemic treatment.

Abbreviations: SLE, systemic lupus erythematosus; NSAIDs, nonsteroidal anti-inflammatory drugs.

Figure 1 Duration of treatment associated with individual drug classes.

Notes: All were systemic treatment; IQR: 25%–75%.
Abbreviations: IQR, interquartile range; NSAIDs, nonsteroidal anti-inflammatory drugs; SD, standard deviation.

Figure 2 Maintenance dose of orally administered corticosteroids with therapy duration of at least 30 days.

Note: Circles denote outliers.

Figure 3 Prescription patterns depending on provider types.

Note: All were systemic treatment.
Abbreviation: NSAIDs, nonsteroidal anti-inflammatory drugs.

Table 3 Prescription patterns for SLE patients followed by major provider groups

Drug class	Active substance	Rheumatology		Primary care		P-value*
		Patient no (%)	Patient-days (%)	Patient no (%)	Patient-days (%)
NSAIDs	Celecoxib	86 (42.2)	13,757 (48.2)	58 (2.6)	3,447 (9.0)	<0.001
	Dexibuprofen	4 (2.0)	32 (0.1)	490 (21.8)	5,676 (14.8)
	Ibuprofen	3 (1.5)	28 (0.1)	102 (4.5)	663 (1.7)
	Loxoprofen	5 (2.5)	784 (2.7)	801 (35.6)	10,103 (26.4)
	Meloxicam	42 (20.6)	6,199 (21.7)	140 (6.2)	7,334 (19.1)
	Nabumetone	37 (18.1)	4,277 (15.0)	37 (1.6)	2,940 (7.7)
	Naproxen	17 (8.3)	2,289 (8.0)	28 (1.2)	597 (1.6)
	Sulindac	3 (1.5)	376 (1.3)	3 (0.1)	167 (0.4)
	Talniflumate	4 (2.0)	478 (1.7)	355 (15.8)	4,508 (11.8)
	Others	3 (1.5)	333 (1.2)	233 (10.4)	2,887 (7.5)
	Total	204 (100)	28,553 (100)	2,247 (100)	38,322 (100)
Antimalarial	Hydroxychloroquine	493 (100)	134,607 (100)	117 (100)	20,801 (100)	<0.001
Corticosteroids	Deflazacort	44 (8.0)	11,052 (10.3)	19 (1.2)	1,491 (5.2)	<0.001
	Dexamethasone inj	18 (3.3)	50 (0.0)	403 (25.9)	1,626 (5.6)
	Hydrocortisone	0 (0.0)	0 (0.0)	27 (1.7)	336 (1.2)
	Methylprednisolone	94 (17.0)	18,094 (16.9)	504 (32.4)	8,912 (30.9)
	Methylprednisolone inj	36 (6.5)	285 (0.3)	14 (0.9)	18 (0.1)
	Prednisolone	319 (57.7)	72,278 (67.6)	350 (22.5)	8,254 (28.6)
	Triamcinolone	31 (5.6)	5,171 (4.8)	96 (6.2)	7,385 (25.6)
	Others	11 (2.0)	27 (0.0)	143 (9.2)	805 (2.8)
	Total	553 (100)	106,957 (100)	1,556 (100)	28,827 (100)
Immunosuppressants	Azathioprine	71 (28.7)	17,660 (46.1)	6 (12.2)	981 (23.3)	<0.001
	Cyclophosphamide inj	14 (5.7)	53 (0.1)	0 (0.0)	0 (0.0)
	Leflunomide	23 (9.3)	5,634 (14.7)	9 (18.4)	1,724 (41.0)
	Methotrexate	93 (37.7)	3,235 (8.5)	32 (65.3)	1,125 (26.8)
	Methotrexate inj	1 (0.4)	31 (0.1)	1 (2.0)	15 (0.4)
	Mycophenolate	45 (18.2)	11,665 (30.5)	1 (2.0)	359 (8.5)
	Total	247 (100)	38,278 (100)	49 (100)	4,204 (100)

Notes: All orally administered agents unless otherwise noted.

* P-values were calculated with the use of the chi-square test.

Abbreviations: inj, injectable; NSAIDs, nonsteroidal anti-inflammatory drug; SLE, systemic lupus erythematosus.