Drugs used in incident systemic lupus erythematosus – results from the Finnish nationwide register 2000–2007

Abstract

The objectives of the study were to examine the initial, first-year anti-rheumatic outpatient therapy in patients with incident SLE, as well as the concomitant use of drugs for certain comorbidities, compared to the use in the general population. The Finnish nationwide register data on special reimbursements for medication costs was screened to identify the inception cohort of 566 adult SLE patients (87% females, mean age 46.5 AE 15.9 years) over the years [2000][2001][2002][2003][2004][2005][2006][2007]. The patients were linked to the national Drug Purchase Register. Of those, 90% had purchased at least once some disease-modifying anti-rheumatic drugs (DMARDs) during the first year. Hydroxychloroquine was the most common (76%), followed by azathioprine (15%) and methotrexate (13%). With the exception of increase in mycophenolate mofetil, the proportions remained stable over the whole study period 2000-2007. Drugs for cardiovascular diseases, dyslipidemia, diabetes mellitus, hypothyroidism and obstructive pulmonary disease were more frequently purchased than in the sex-and age-adjusted population, with rate ratios ranging from 1.6 to 7.8. Over the years 2000-2007, almost all the patients with incident SLE in Finland started with a DMARD. Higher percentages of SLE patients were on medication for several common chronic diseases than in the population as a whole. Lupus (2016) 25, 666-670.

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“…In the present study, it was used in the treatment of almost 37% of SLE patients .The Saudi study reported comparable findings where third of patients received AZA [27], whereas it was used in very small number of Iraqi patients [35]. A European Finnish nationwide register data reported that 15% of their patients used AZA [22], whereas AZA is often preferred in Asia due to economic constraints and because of its safety in pregnancy [7].…”

“…Saudi studies reported a similar finding where almost 100% of their SLE patients treated with HCQ [20,21]. Finnish nationwide register data reported that almost 73% of their patients were on HCQ [22]. AMs are also increasingly recognized as having beneficial effects beyond disease control and damage prevention, In particular it has a protective effect against thrombosis and loss of bone mass, It also improves lipid profiles and maternal outcomes during pregnancy [1,[23][24][25].…”

Multimorbidity among incident Finnish systemic lupus erythematosus patients during 2000–2017

“…Hydroxychloroquinine has been shown to decrease prevalence of chronic kidney disease, and at least in Finland it is often used as the primary medicine in SLE treatment. 25,26 Another explanation for our result may be that almost all of our patients were native Finnish. SLE affects nervous system inducing neuropsychiatric disorders (neuropsychiatric SLE, NPSLE).…”

Impact of Endocrine Disorders on Autoimmune Diseases

“…Medications for diabetes were used more often in the incident SLE cohort than in the general population OR 1.64 (1.20-2.45). Although glucocorticoids may induce diabetes, in this cohort exposure to glucocorticoids was of short duration (Elfving et al 2016). Data from the Toronto risk factor study on 250 SLE patients and controls showed an increased risk of DM in SLE patients (5% vs. 1%, RR = 6 (1.36-26.5)) (Bruce et al 2003).…”