Study type

Study type

Non-interventional study

Scope of the study

Effectiveness study (incl. comparative)
Safety study (incl. comparative)
Non-interventional study

Non-interventional study design

Other

Non-interventional study design, other

Multi-center, prospectiv, observational cohort study
Study drug and medical condition

Name of medicine

Benlysta

Medical condition to be studied

Systemic lupus erythematosus
Population studied

Age groups

Adults (18 to < 46 years)
Adults (46 to < 65 years)
Adults (65 to < 75 years)
Adults (75 to < 85 years)
Adults (85 years and over)

Estimated number of subjects

3000
Study design details

Main study objective

Evaluate the incidence of following AESI over 5 years in adults with active auto antibody positive SLE treated with/without BENLYSTA: Malignancies, Mortality, Opportunistic infections & other infections of interest, Non-melanoma skin cancer, Selected serious psychiatric event, Serious infections.

Outcomes

Incidence of the following adverse events of special interest (AESI):
- Malignancies (excluding non-melanoma skin cancers)
- Mortality
- Opportunistic infections and other infections of interest (Appendix 1)
- Non-melanoma skin cancers (NMSC)
- Selected serious psychiatric events (Appendix 2)
- Serious infections

Evaluate the effectiveness measures in adults with active autoantibody-positive SLE treated with/without BENLYSTA:
- Organ damage assessed by SLICC/ACR Damage Index
- Concomitant SLE meds including steroids
- Hospitalization
- Quality of life assessed by SF-12v2 Health Survey
- Fatigue assessed by FACIT-Fatigue Scale
- SLE disease activity assessed by SLEDAI 2000
- Severe Flare derived by SLE Flare Index

Data analysis plan

Estimate AESI via incidence rates & compared between cohorts using binomial regression and/or Cox models / Kaplan-Meier plots based on one or more exposure strategies as described:
(1, 2) patients contribute data until their first treatment switch, or a pre-specified landmark timepoint,
(3) Ever-taken Benlysta strategy, an event will be attributed to BENLYSTA if the patient was ever exposed to BENLYSTA prior to the event, & to non-Benlysta otherwise,
(4) patient profile approach, patients are characterized by the switch patterns,
(5) the as-exposed analysis or marginal structural methods may be used to model treatment switch and explore the long-term treatment effect. Safety analysis may employ a lagged risk window since an AE may be attributed to a treatment after discontinuation. Similar methods will be applied to the effectiveness endpoints. Propensity score methods and/or multivariate regression methods will be used to adjust for potential confounding factors & selection bias.