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Abstract: FR-PO608

Substantial Economic Burden Associated With the Management of Lupus Nephritis in Adult Patients in the United States

Session Information

Category: Glomerular Diseases

  • 1302 Glomerular Diseases: Immunology and Inflammation


  • Rovin, Brad H., The Ohio State University, Columbus, Ohio, United States
  • Ma, Janice, Maple Health Group, New York, New York, United States
  • Pisarczyk, Konrad, Maple Health Group, New York, New York, United States
  • Leff, Richard, Kezar Life Sciences Inc, South San Francisco, California, United States
  • Park, Eunmi, Kezar Life Sciences Inc, South San Francisco, California, United States
  • Long, Li, Kezar Life Sciences Inc, South San Francisco, California, United States

Lupus nephritis (LN) is a serious complication of systemic lupus erythematosus (SLE) associated with considerable morbidity, including an increased risk of end-stage kidney diseases (ESKD) that may impose a substantial economic burden on the healthcare system. Recently, a systematic literature review showed increased costs and healthcare resource utilization (HCU) associated with LN globally but there is a need to better understand the economic impact of the disease in the United States (US). This study aimed to summarize the evidence on costs and HCU related to the management of LN in adult patients in the US.


A comprehensive targeted literature review was conducted in MEDLINE and Embase to identify studies in patients with adult and juvenile onset of LN, published in English between March 2012 and 2022. The search included conference abstracts indexed in Embase since 2019.


Of 4,216 records identified in the medical databases, 8 US studies reported on costs and HCU in adults with LN. The majority of studies were conducted based on nationwide claims and inpatient databases. On average, patients with LN had significantly higher utilization of outpatient visits related to spectrum of care (e.g., primary care, neurology, nephrology, dermatology) and hospitalizations per year with approximately 6-day longer lengths of stay, compared to matched subjects without SLE or LN. The mean annual healthcare cost ranged from $33,500 to $51,000, being the highest in the first year following LN diagnosis ($44,205), and 5-7-times higher than in matched non-SLE/LN controls (p<0.05). The main cost drivers were related to inpatient care followed by ambulatory and pharmacy costs. LN-related ESKD and active LN led to excess costs compared to periods of low disease activity, with mean monthly healthcare cost of $22,000 and $6,600 vs $1,100, respectively.


LN is associated with significant economic burden on the US healthcare system. The total cost of care is notably high in patients suffering active disease and those developing ESKD, which confirms the urgency of need for effective therapies to treat LN and prevent its complications.


  • Commercial Support – Kezar Life Sciences, Inc.