POS1112 TRENDS IN NATIONAL HOSPITALISATIONS FOR SYSTEMIC LUPUS ERYTHEMATOSUS, IDIOPATHIC INFLAMMATORY MYOPATHIES AND SYSTEMIC SCLEROSIS OVER THE LAST 25 YEARS IN ENGLAND
Authors: M. Ong, M. Russell, J. Galloway, C. Wincup
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Systemic lupus erythematosus (SLE), idiopathic inflammatory myopathies (IIM) and systemic sclerosis (SSc) are complex multi-system diseases with substantial risk of hospitalisation and morbidity. The introduction of targeted therapies has improved prognosis for patients; however, it remains unclear whether this has impacted on hospitalisations for these conditions. <h3>Objectives:</h3> To describe trends in acute hospital admissions due to SLE, IIM and SSc in England between April 1998 to March 2023. <h3>Methods:</h3> An ecological study was performed to evaluate temporal trends in hospital admissions (emergency vs. day-case admissions) and lengths of admissions with primary diagnoses of SLE, IIM or SSc using the Hospital Episode Statistics dataset, which contains data on all admissions to National Health Service (NHS) hospitals in England. Data collected was specific to cases coded in which the cause of admission was directly attributed to the underlying disease (rather than an admission resulting from an infection or alternative cause for acute presentation in the context of known systemic autoimmune rheumatic disease). <h3>Results:</h3> As showing in Figure 1A, emergency admissions due to SLE decreased by 36% in England between April 1998 and March 2023, from 1.89 to 1.21 admissions per 100,000 population (p&lt;0.001). Similarly, there was a 25% reduction in emergency admissions from IIM (from 0.56 to 0.42 admissions per 100,000 population, p&lt;0.001), and 63% reduction in SSc admissions (from 0.61 to 0.22 admissions per 100,000 population, p&lt;0.001). The number of attributable hospital bed-days per 100,000 population decreased by 56%, 44% and 78% for SLE, IIM and SSc, respectively (Figure 1B). Marked decreases in emergency admissions were observed for SLE and SSc, but not IIM, in the first year of the COVID-19 pandemic. In contrast to the observed decreases in emergency admissions, day-case admissions per 100,000 population for SLE, IIM and SSc increased by 209%, 535% and 169%, respectively, over the study period (Figure 1C). <h3>Conclusion:</h3> Acute admissions due to SLE, IIM and SSc have decreased markedly in England over the last 25 years. This may be a result of improved early recognition and aggressive treatment of flares of these diseases. Furthermore, a substantial number of targeted therapies/ biologics have been licensed for therapy for these conditions in the last 25 years. In contrast, day-case admissions increased manyfold, which likely reflects how advances in the treatment of these conditions (often delivered through these day-case admission) have resulted in improved outcomes and reduced costly unplanned emergency admissions. The decrease in emergency admission in year 2019 to 2020 is attributed to COVID-19 pandemic as patients with these conditions are more likely to have reservations to present to hospital as they are often on immunosuppressive therapies. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Melissa Ong: None declared, Mark Russell has received honoraria from AbbVie, Lilly, Galapagos, Menarini and Viforpharma, advisory board fees from Biogen, and support for attending educational meetings from Lilly, Pfizer, Janssen and UCB., James Galloway has received honoraria from Abbvie, Biovitrum, BMS, Celgene, Chugai, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi, Sobi and UCB., Chris Wincup has received honoraria from UCB; research funding from AstraZeneca; support for attending educational meetings from Abbvie.