Assessing the Costs of Neuropsychiatric Disease in the Systemic Lupus International Collaborating Clinics Cohort Using Multistate Modeling.


Journal

Arthritis care & research
ISSN: 2151-4658
Titre abrégé: Arthritis Care Res (Hoboken)
Pays: United States
ID NLM: 101518086

Informations de publication

Date de publication:
09 2023
Historique:
revised: 19 12 2022
received: 05 07 2022
accepted: 19 01 2023
pmc-release: 01 09 2024
medline: 31 8 2023
pubmed: 25 1 2023
entrez: 24 1 2023
Statut: ppublish

Résumé

To estimate direct and indirect costs associated with neuropsychiatric (NP) events in the Systemic Lupus International Collaborating Clinics inception cohort. NP events were documented annually using American College of Rheumatology definitions for NP events and attributed to systemic lupus erythematosus (SLE) or non-SLE causes. Patients were stratified into 1 of 3 NP states (no, resolved, or new/ongoing NP event). Change in NP status was characterized by interstate transition rates using multistate modeling. Annual direct costs and indirect costs were based on health care use and impaired productivity over the preceding year. Annual costs associated with NP states and NP events were calculated by averaging all observations in each state and adjusted through random-effects regressions. Five- and 10-year costs for NP states were predicted by multiplying adjusted annual costs per state by expected state duration, forecasted using multistate modeling. A total of 1,697 patients (49% White race/ethnicity) were followed for a mean of 9.6 years. NP events (n = 1,971) occurred in 956 patients, 32% attributed to SLE. For SLE and non-SLE NP events, predicted annual, 5-, and 10-year direct costs and indirect costs were higher in new/ongoing versus no events. Direct costs were 1.5-fold higher and indirect costs 1.3-fold higher in new/ongoing versus no events. Indirect costs exceeded direct costs 3.0 to 5.2 fold. Among frequent SLE NP events, new/ongoing seizure disorder and cerebrovascular disease accounted for the largest increases in annual direct costs. For non-SLE NP events, new/ongoing polyneuropathy accounted for the largest increase in annual direct costs, and new/ongoing headache and mood disorder for the largest increases in indirect costs. Patients with new/ongoing SLE or non-SLE NP events incurred higher direct and indirect costs.

Identifiants

pubmed: 36691838
doi: 10.1002/acr.25090
pmc: PMC10363569
mid: NIHMS1868764
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

1859-1870

Subventions

Organisme : NCRR NIH HHS
ID : M01 RR000046
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001422
Pays : United States
Organisme : NIAMS NIH HHS
ID : P30 AR072579
Pays : United States
Organisme : NIAMS NIH HHS
ID : R01 AR043727
Pays : United States
Organisme : NIAMS NIH HHS
ID : R01 AR069572
Pays : United States
Organisme : NIAMS NIH HHS
ID : P60 AR064464
Pays : United States
Organisme : NIAMS NIH HHS
ID : P60 AR048098
Pays : United States
Organisme : NIAMS NIH HHS
ID : K24 AR002138
Pays : United States
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Department of Health
Pays : United Kingdom
Organisme : NCATS NIH HHS
ID : UL1 TR000150
Pays : United States
Organisme : NCRR NIH HHS
ID : UL1 RR025741
Pays : United States
Organisme : NIAMS NIH HHS
ID : P30 AR072579
Pays : United States

Informations de copyright

© 2023 American College of Rheumatology.

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Auteurs

Ann E Clarke (AE)

University of Calgary, Calgary, Alberta, Canada.

John G Hanly (JG)

Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada.

Murray B Urowitz (MB)

Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada.

Yvan St Pierre (Y)

McGill University Health Center, Montreal, Quebec, Canada.

Caroline Gordon (C)

University of Birmingham, Birmingham, UK.

Sang-Cheol Bae (SC)

Hanyang University Hospital for Rheumatic Diseases and Hanyang University, Seoul, Republic of Korea.

Juanita Romero-Diaz (J)

Instituto Nacional de Ciencias Médicas y Nutricion, Mexico City, Mexico.

Jorge Sanchez-Guerrero (J)

Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada.

Sasha Bernatsky (S)

McGill University Health Center, Montreal, Quebec, Canada.

Daniel J Wallace (DJ)

Cedars-Sinai and University of California, Los Angeles.

David A Isenberg (DA)

University College London, London, UK.

Anisur Rahman (A)

University College London, London, UK.

Joan T Merrill (JT)

Oklahoma Medical Research Foundation, Oklahoma City.

Paul R Fortin (PR)

CHU de Québec-Université Laval, Quebec City, Quebec, Canada.

Dafna D Gladman (DD)

Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada.

Ian N Bruce (IN)

The University of Manchester and Central Manchester University Hospitals National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.

Michelle Petri (M)

Johns Hopkins University School of Medicine, Baltimore, Maryland.

Ellen M Ginzler (EM)

State University of New York Downstate Health Sciences University, Brooklyn.

Mary Anne Dooley (MA)

University of North Carolina, Chapel Hill.

Rosalind Ramsey-Goldman (R)

Northwestern University, Chicago, Illinois.

Susan Manzi (S)

Alleghany Health Network, Pittsburgh, Pennsylvania.

Andreas Jönsen (A)

Lund University, Lund, Sweden.

Graciela S Alarcón (GS)

University of Alabama at Birmingham.

Ronald F Van Vollenhoven (RF)

Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Cynthia Aranow (C)

Feinstein Institute for Medical Research, Manhasset, New York.

Meggan Mackay (M)

Feinstein Institute for Medical Research, Manhasset, New York.

Guillermo Ruiz-Irastorza (G)

University of the Basque Country, Barakaldo, Spain.

S Sam Lim (SS)

Emory University School of Medicine, Atlanta, Georgia.

Murat Inanc (M)

Istanbul University, Istanbul, Turkey.

Kenneth C Kalunian (KC)

University of California San Diego, La Jolla.

Soren Jacobsen (S)

Rigshospitalet and Copenhagen University Hospital, Copenhagen, Denmark.

Christine A Peschken (CA)

University of Manitoba, Winnipeg, Manitoba, Canada.

Diane L Kamen (DL)

Medical University of South Carolina, Charleston.

Anca Askanase (A)

Hospital for Joint Diseases and New York University Seligman Center for Advanced Therapeutics, New York, New York.

Vernon Farewell (V)

University of Cambridge, Cambridge, UK.

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