An Analysis of Adherence to Pharmacotherapy, Effectiveness, Drug Use Pattern and Safety in Systemic Lupus Erythematosus Patients at Tertiary Care Teaching Hospital

Background and Aims: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that needs long-term treatment. Treatment success depends on the effectiveness of these medications and how well patients follow their treatment plans. This research aims to fill this gap by assessing whether there is an association between treatment adherence and the effectiveness of the treatment. To evaluate adherence to pharmacotherapy, treatment effectiveness, drug use patterns and the safety of SLE therapy. Materials and Methods: This was a prospective observational study conducted over 18 months, from February 2023 to July 2024. Patients were followed up at 6 and 12 months. During each visit, they were interviewed in their local language using the Morisky Medication Adherence Scale to assess how well they were following their treatment. The effectiveness of treatment was measured using the SLE disease activity index 2000 (SLEDAI-2K) Responder Index 50 (SRI-50) scale, based on patients’ symptom improvements and lab test results. Results: A total of 47 patients were included. Over 12 months, low and medium adherence slightly increased, while high adherence decreased. Mean SLEDAI-2K scores improved significantly from 11.6 at baseline to 5.97 at 6 months and 4.63 at 12 months, with 47.36% much improved, 10.52% moderately improved, and 10.52% slightly improved, while 18.42% remained unchanged and only a small proportion worsened. Hydroxychloroquine was most frequently prescribed (95.14%), followed by prednisolone (82.97%), methotrexate (38.29%) and azathioprine (19.14%). Conclusions: Treatment of SLE showed good effectiveness with a marked reduction in disease activity over 12 months. However, adherence declined slightly.