Lupus nephritis (LN), a common manifestation of systemic lupus erythematosus (SLE), is associated with substantial healthcare resource utilization (HCRU) and has an estimated prevalence of 15 per 100,000 in Germany.

The current complex treatment pathways for LN, and disease burden experienced by patients, require further understanding to improve outcomes with targeted new therapies; this real-world study characterized treatment patterns, HCRU, and costs in patients with active LN initiating immunosuppressant therapy using administrative claims data.

Most German patients with LN initiating immunosuppressants had ≥ 1 treatment discontinuation over the 4-year follow-up period, with a smaller proportion switching therapies; in addition, these patients received high doses of corticosteroids even after initiation of immunosuppressants.

There was considerable HCRU and economic burden seen in patients with LN compared with the non-SLE/LN control group: a higher proportion of patients with LN had hospitalizations, ambulant hospital visits, outpatient visits, outpatient prescriptions, and remedies and other benefits; costs were also higher across all years of follow-up, particularly in year 1 where costs were nearly four times higher in patients with LN compared with the control group.

Current treatment pathways for LN in Germany may not provide adequate disease management, necessitating more effective, well-tolerated treatments.