Background Previous epidemiologic studies of cutaneous lupus erythematosus (CLE) have not described the pediatric burden, and have focused on specific geographic areas, limiting generalizability.
Objectives To describe the demographics, comorbid conditions and pharmacy drug utilization of CLE patients, 3 large sources of U.S. administrative claims data: 1) commercial insurance, 2) Medicaid insurance, and 3) Medicare insurance were utilized.
Methods The data source was Truven Health MarketScan® Databases, containing medical service and prescription drug claims from commercial, Medicaid (11 states) and Medicare supplemental insurance plans for >80M US patients. CLE cases were identified by presence of ≥2 service dates with an ICD-9 code 695.4 on unique dates ≥28 days apart during the study period (Jan 1 2010-Dec 31 2014). For the most recent study year, the 5 most frequent comorbidity categories were reported using Clinical Classifications Software (CCS) Level 2 groupings. Similarly, the 5 most frequent pharmacy dispensings among CLE cases in 2014 were reported.
Results In the Commercial, Medicaid, and Medicare claims data, 35,781, 7,361 and 5,594 CLE patients, respectively, were identified. CLE cases were >80% female with <6% aged <19 (Table). The most frequent CCS category (in all databases except Medicare) was CCS 13.7 (SLE and connective tissue disorders including systemic sclerosis, sicca syndrome, dermatomyositis, and polymyositis) where 63.1%, 76.6%, and 59.4% of CLE cases in the Commercial/Medicaid/Medicare data, respectively, had ≥1 claim. The most frequently-dispensed medication was corticosteroid hormone (62.5%, 72.1%, and 62.3% in the Commercial/Medicaid/Medicare data), while antimalarials were used by 58.3%, 55.9%, and 52.1% of CLE patients in the 3 databases, respectively.
Conclusions Our results document a low relative burden of pediatric CLE. Notably, 23 to 41% of CLE patients did not have a claim for SLE or other connective tissue disease. Limitations include the inability of code 695.4 to distinguish between CLE subtypes, including discoid and subacute cutaneous lupus.
Disclosure of Interest S. Hall Shareholder of: Biogen, Employee of: Biogen, L. Li Shareholder of: Biogen, Employee of: Biogen, S. Eaton Shareholder of: Biogen, Employee of: Biogen, C. Musselli Shareholder of: Biogen, Employee of: Biogen, A. Dilley Shareholder of: Biogen, Employee of: Biogen
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