Qualità di vita e priorità di assistenza, in L’impiego di belimumab nel Lupus Eritematoso Sistemico: risultati di una valutazione di HTA

[Autom. eng. transl.] Patients with SLE, especially in the course of disease activity, present a functional status usually compromised with respect to the general population and a decrease in QoL not only in the sphere of physical functionality but also in the emotional sphere. The reduction of HR-QoL (Health Related Quality of Life) of patients with SLE is comparable to that of serious diseases such as AIDS or other chronic diseases such as rheumatoid arthritis, hypertension, congestive heart failure, diabetes mellitus and myocardial infarction. The studies available up to now on the impact of belimumab on QoL show a significant improvement compared to the control group confirming the positive effect of the drug on the different dimensions of HR-QoL. There is a difficulty in the diagnosis of SLE, often late, largely due to the insidious onset of the disease. Patients with SLE frequently need the advice and active collaboration of several specialists (rheumatologists, internists, nephrologists, immunologists and dermatologists) made difficult by the low prevalence of the disease, by the late diagnosis, by the strong inter- and intra-regional inhomogeneity in the 'access to new therapies, especially if infusional, and to the lack of specific Therapeutic Care Diagnostic Pathways (PDTAs) specific for LES patients. A survey conducted in 2011 in Italy showed that 1 hospital center out of 4 treats the LES. Only in 55% of the centers that treat LES are infusion therapies practiced with biological drugs commonly used in the treatment of other pathologies. The complexity of taking care of the patient and the use of drugs in an off-label mode bring out a need for health that makes the patient with SLE even more difficult. In this context, belimumab would help to bridge the therapeutic gap for this disease, bringing added value in terms of offering appropriate treatments and improving QoL.