Background Evidence based international guidelines for the treatment of systemic lupus erythematosus (SLE) recommend anti-malarias (AMs) are taken by all SLE patients irrespective of disease activity. Only few studies have investigated the use of AMs among newly diagnosed patients with SLE.
Objectives To analyze prescription patterns of AMs in newly diagnosed SLE patients in Denmark for the years 2000 -2011.
Methods Using The Danish Prescription Register (DNPR) we conducted a nationwide Danish cohort study including all patients with a first time diagnosis of SLE (The Danish National Registry of Patients (NPR)). We used Kaplan-Meier estimates to compute the cumulative probability of starting AM treatment within a year and Cox regression analysis to compare time to treatment between patient groups.
Results AMs were prescribed to 37.7% of the newly diagnosed SLE patients within the first year of follow-up. Approximately 20% did not receive any treatment. Women were more likely than men to start AM (adjusted HR of 1.26 (95% CI 1.06-1.50)). Patients diagnosed with SLE between in 2005-2011 were more likely to start treatment than patients diagnosed in 2000-2004 (HR of 1.33 (95% CI 1.17-1.51)). Patients with renal disease were less likely to start AM treatment than patients without this condition (adjusted HR of 0.67 (95% CI 0.56-0.83)). Current users of prednisolone were more likely to start AM treatment than non-users ((adjusted HR 1.93 (95% CI 1.68-2.23).
Conclusions Our results showed that more Danish SLE patients should be prescribed AMs, especially patients with renal disease, to be in agreement with evidence based international guidelines.
Acknowledgements For making this project possible, we wish to thank the following institutions: Institute of Clinical Medicine, Aarhus University. Department of Rheumatology, Aarhus University Hospital. Department of Clinical Epidemiology, Aarhus University Hospital and Gigtforenningen. There were no conflicts of interest.
Disclosure of Interest None declared