TOPLINE:

More than half of adult patients with systemic lupus erythematosus (SLE) had polypharmacy, defined as the concurrent use of five or more medications, a cross-sectional study found. Polypharmacy was more common among older adults and was mostly driven by non-immunomodulatory drugs such as antihypertensives and nonopioid pain relievers.

METHODOLOGY:

• Researchers conducted a cross-sectional study of 451 patients (mean age, 46.2 years; 91.8% women; 81.8% Black) with SLE to estimate the prevalence of polypharmacy and to identify the most common medications used.
• Data were collected via performance tests and questionnaires during a one-time study visit between October 8, 2019, and May 12, 2022.
• Information on demographics, insurance, and other SLE-related factors was collected.
• Analysis assessed the reported number of individual prescriptions or over-the-counter medications; eye drops, topical agents, inhalants, and supplements were excluded.

TAKEAWAY:

• More than half of participants (56.3%) had polypharmacy; 23.3% met the criteria for hyperpolypharmacy (the use of 10 or more medications).
• Polypharmacy was more frequent with increasing age (68.1% for ages ≥ 60 years vs 43.0% for ages 18-39 years) and was higher in men vs women (67.6% vs 55.3%); it was also linked to greater disease activity, more cumulative disease damage, longer disease duration, and the use of 3-5 vs 0-1 immunomodulating drugs.
• Although hydroxychloroquine (71.4%), glucocorticoids (44.3%), and other immunomodulating drugs (50.3%) were common, polypharmacy was primarily driven by medications such as antihypertensives (61.9%) and nonopioid pain relievers (51.7%).

IN PRACTICE:

“[The study] results emphasize the need to address the complexity of medication regimens in this population through patient-centered medication optimization efforts,” the authors wrote.

SOURCE:

The study was led by Jianing Yang, DO, Alameda Health System in Oakland, California. It was published online on October 24, 2025, in Arthritis Care & Research.

LIMITATIONS:

Medication use was self-reported, which may have led to underreporting or overreporting of polypharmacy. The study did not collect information on medication duration, dose, and frequency, potentially overestimating the prevalence of polypharmacy. It is unknown whether over-the-counter medications were started by patients themselves or advised by a rheumatologist or another clinician.

DISCLOSURES:

The study was supported by the National Institute on Aging and CDC. Some authors reported receiving support for attending meetings and travel, research support, grants or contracts, royalties or licenses, consulting fees, payments, or honoraria from; serving in leadership roles for; and having other ties with various pharmaceutical companies and institutions.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.