TY  - JOUR
N1  - This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions.
PB  - Wiley
SP  - 1859
TI  - Assessing the Costs of Neuropsychiatric Disease in the Systemic Lupus International Collaborating Clinics (SLICC) Cohort using Multistate Modelling
Y1  - 2023/09//
UR  - https://doi.org/10.1002/acr.25090
VL  - 75
A1  - Clarke, Ann E
A1  - Hanly, John G
A1  - Urowitz, Murray B
A1  - St Pierre, Yvan
A1  - Gordon, Caroline
A1  - Bae, Sang-Cheol
A1  - Romero-Diaz, Juanita
A1  - Sanchez-Guerrero, Jorge
A1  - Bernatsky, Sasha
A1  - Wallace, Daniel J
A1  - Isenberg, David A
A1  - Rahman, Anisur
A1  - Merrill, Joan T
A1  - Fortin, Paul R
A1  - Gladman, Dafna D
A1  - Bruce, Ian N
A1  - Petri, Michelle
A1  - Ginzler, Ellen M
A1  - Dooley, Mary Anne
A1  - Ramsey-Goldman, Rosalind
A1  - Manzi, Susan
A1  - Jönsen, Andreas
A1  - Alarcón, Graciela S
A1  - Van Vollenhoven, Ronald F
A1  - Aranow, Cynthia
A1  - Mackay, Meggan
A1  - Ruiz-Irastorza, Guillermo
A1  - Lim, S Sam
A1  - Inanc, Murat
A1  - Kalunian, Kenneth C
A1  - Jacobsen, Soren
A1  - Peschken, Christine A
A1  - Kamen, Diane L
A1  - Askanase, Anca
A1  - Farewell, Vernon
EP  - 1870
JF  - Arthritis Care & Research
AV  - public
N2  - OBJECTIVE: To estimate direct and indirect costs (DC, IC) associated with neuropsychiatric (NP) events in the SLICC Inception Cohort. METHODS: NP events were documented annually using ACR NP definitions and attributed to SLE or non-SLE causes. Patients were stratified into one of three NP states (no, resolved, or new/ongoing NP event). Change in NP status was characterized by inter-state transition rates using multi-state modelling. Annual DC and IC were based on healthcare 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 modelling. RESULTS: 1697 patients (49% White race/ethnicity) were followed a mean of 9.6?years. NP events (n=1971) occurred in 956 patients, 32% attributed to SLE. For SLE and non-SLE NP events, predicted annual, five, and 10-year DC and IC were higher in new/ongoing versus no events. DC were 1.5-fold higher and IC 1.3-fold higher in new/ongoing versus no events. IC exceeded DC 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 DC. For non-SLE NP events, new/ongoing polyneuropathy accounted for the largest increase in annual DC and new/ongoing headache and mood disorder for the largest increases in IC. CONCLUSION: Patients with new/ongoing SLE or non-SLE NP events incurred higher DC and IC.
ID  - discovery10163812
IS  - 9
ER  -