Table 1.
Patient baseline demographics, disease characteristics, and disease severity (N = 27,353)
| No OCS use (n = 11,137) | OCS initiation (n = 16,216) | P value | |
|---|---|---|---|
| Age, mean (SD), y | 47.3 (13.8) | 44.9 (13.4) | <0.01 |
| Age category, n (%), y | |||
| 5‐17 | 192 (1.7) | 488 (3.0) | <0.01 |
| ≥18 | 10,945 (98.3) | 15,728 (97.0) | <0.01 |
| Sex, n (%) a | |||
| Female | 9942 (89.3) | 14,705 (90.7) | <0.01 |
| Region, n (%) | |||
| South | 3623 (32.5) | 6196 (38.2) | <0.01 |
| Northeast | 2735 (24.6) | 3641 (22.5) | <0.01 |
| Midwest | 2394 (21.5) | 3675 (22.7) | 0.02 |
| West | 2276 (20.4) | 2567 (15.8) | <0.01 |
| Unknown | 108 (1.0) | 137 (0.8) | 0.28 |
| Insurance type, n (%) b | |||
| Commercial | 6672 (59.9) | 9461 (58.3) | 0.01 |
| Medicare | 330 (3.0) | 286 (1.8) | <0.01 |
| Medicaid | 1040 (9.3) | 1291 (8.0) | <0.01 |
| Self‐insured | 3076 (27.6) | 5216 (32.2) | <0.01 |
| Other/unknown | 67 (0.6) | 76 (0.5) | 0.13 |
| Year of index date, n (%) | |||
| 2006‐2007 | 1325 (11.9) | 2060 (12.7) | 0.05 |
| 2008‐2009 | 1911 (17.2) | 2993 (18.5) | <0.01 |
| 2010‐2011 | 1616 (14.5) | 2572 (15.9) | <0.01 |
| 2012‐2013 | 1803 (16.2) | 2631 (16.2) | 0.94 |
| 2014‐2015 | 2284 (20.5) | 3246 (20.0) | 0.32 |
| 2016‐2017 | 1871 (16.8) | 2419 (14.9) | <0.01 |
| 2018 | 327 (2.9) | 295 (1.8) | <0.01 |
| Physician specialty, n (%) | |||
| Primary care c | 2374 (21.3) | 3605 (22.2) | 0.07 |
| Rheumatologist | 2422 (21.7) | 3552 (21.9) | 0.76 |
| Quan–Charlson Comorbidity Index, mean (SD) | 1.5 (1.1) | 1.6 (1.2) | <0.01 |
| Comorbidities, n (%) b , d | |||
| Cardiovascular disease | 4194 (37.7) | 6221 (38.4) | 0.24 |
| Hypertension | 3803 (34.1) | 5580 (34.4) | 0.65 |
| Cerebrovascular disease | 574 (5.2) | 813 (5.0) | 0.60 |
| Congestive heart failure | 410 (3.7) | 625 (3.9) | 0.46 |
| Peripheral vascular disease | 387 (3.5) | 543 (3.3) | 0.57 |
| Myocardial infarction | 168 (1.5) | 276 (1.7) | 0.21 |
| Stroke | 202 (1.8) | 251 (1.5) | 0.09 |
| Infections e | 4207 (37.8) | 6553 (40.4) | <0.01 |
| Immunoinflammation related | 1471 (13.2) | 2492 (15.4) | <0.01 |
| Rheumatoid arthritis | 1192 (10.7) | 2050 (12.6) | <0.01 |
| Thyroiditis | 194 (1.7) | 292 (1.8) | 0.72 |
| Inflammatory bowel disease | 128 (1.1) | 224 (1.4) | 0.09 |
| Renal disease | 956 (8.6) | 1600 (9.9) | <0.01 |
| Diabetes | 1212 (10.9) | 1526 (9.4) | <0.01 |
| Osteoporosis | 784 (7.0) | 921 (5.7) | <0.01 |
| Concomitant medications, n (%) b , f | |||
| Antimalarials | 4718 (42.4) | 7865 (48.5) | <0.01 |
| NSAIDs | 2133 (19.2) | 4614 (28.5) | <0.01 |
| Immunosuppressants/biologics | 1368 (12.3) | 2816 (17.4) | <0.01 |
| Disease severity, n (%) | |||
| Mild | 7362 (66.1) | 9091 (56.1) | <0.01 |
| Moderate | 2686 (24.1) | 5248 (32.4) | <0.01 |
| Severe | 1089 (9.8) | 1877 (11.6) | <0.01 |
| SLE flares | |||
| Patients with ≥1 SLE flare, n (%) | 7348 (66.0) | 12,683 (78.2) | <0.01 |
| ≥1 mild SLE flare | 2022 (18.2) | 4389 (27.1) | <0.01 |
| ≥1 moderate SLE flare | 6148 (55.2) | 10,330 (63.7) | <0.01 |
| ≥1 severe SLE flare | 503 (4.5) | 1760 (10.9) | <0.01 |
| Number of any SLE flares per patient, mean (SD) | 1.4 (0.6) | 1.6 (0.7) | <0.01 |
| Health care costs, mean (SD) 2018 USD | |||
| All‐cause total | 12,547 (31,744) | 17,472 (42,039) | <0.01 |
| Medical | 11,087 (31,017) | 15,501 (41,327) | <0.01 |
| Pharmacy | 1460 (5047) | 1970 (5121) | <0.01 |
Abbreviations: NSAID, nonsteroidal antiinflammatory drug; OCS, oral corticosteroid; SLE, systemic lupus erythematosus; USD, United States dollars.
One patient with unknown sex was excluded from subsequent multivariate analysis.
Patients could have more than one value.
Primary care included general practitioner/family practitioner, nurse practitioner, and internal medicine physician.
Identified using International Classification of Diseases, Ninth Revision, Clinical Modification and International Classification of Diseases, Tenth Revision, Clinical Modification codes.
Infections included fungal infections, pneumonia, tuberculosis, urinary tract infection, varicella infection, and sepsis.
Identified using Generic Product Identifier and Healthcare Common Procedure Coding System codes.