Prevalence of systemic lupus erythematosus and age-stratified treatment trends in the Japanese population: A cross-sectional study based on the National Database of Health Insurance Claims

Objectives The aim of this article is to investigate the prevalence of systemic lupus erythematosus (SLE) in Japan and explore its treatment regimens in different age groups.Methods We identified patients with SLE from the National Database of Health Insurance Claims of anonymized health insurance-related information; they had disease names associated with SLE and were treated with glucocorticoids, hydroxychloroquine, or immunosuppressants. These data were used to investigate disease prevalence and profiles in Japan.Results Of 74,277 patients with SLE, 12,816 were men (16.6%) and 61,961 were women (83.4%). Oral glucocorticoids were administered to 89.1% of patients and hydroxychloroquine to 21.4%. Regarding immunosuppressants, mycophenolate mofetil was prescribed for 49.2% of patients aged <= 14 years and tacrolimus for 35.5% of those aged 20-39 years; these rates were higher than those observed in other age groups.Conclusions The high proportion of patients receiving treatment for comorbidities may be partially explained by the high rate of glucocorticoid use, as approval of hydroxychloroquine for the treatment of SLE was delayed in Japan. This is the first study to ascertain the prevalence of SLE and its treatment status in Japan using the National Database, thus providing useful basic data to improve the management of the disease.