Understanding the epidemiology and progression of systemic lupus erythematosus
- PMID: 19136143
- PMCID: PMC2813992
- DOI: 10.1016/j.semarthrit.2008.10.007
Understanding the epidemiology and progression of systemic lupus erythematosus
Abstract
Objectives: This review examines the burden and patterns of disease in systemic lupus erythematosus (SLE) and the influence and interactions of gender, ethnicity, age, and psychosocial attributes with respect to disease progression, focusing on issues relevant to clinical practice and research.
Methods: PubMed literature search complemented by review of bibliographies listed in identified articles.
Results: An increased risk among reproductive age women is clearly seen in African Americans in the United States. However, in other populations, a different pattern is generally seen, with the highest age-specific incidence rates occurring in women after age 40 years. The disease is 2 to 4 times more frequent, and more severe, among nonwhite populations around the world and tends to be more severe in men and in pediatric and late-onset lupus. SLE patients now experience a higher than 90% survival rate at 5 years. The less favorable survival experience of ethnic minorities is possibly related to socioeconomic status rather than to ethnicity per se, and adequate social support has been shown to be a protective factor, in general, in SLE patients. Discordance between physician and patient ratings of disease activity may affect quality of care.
Conclusions: Our understanding of ways to improve outcomes in SLE patients could benefit from patient-oriented research focusing on many dimensions of disease burden. Promising research initiatives include the inclusion of community-based patients in longitudinal studies, use of self-assessment tools for rating disease damage and activity, and a focus on self-perceived disease activity and treatment compliance.
(c) 2010 Elsevier Inc. All rights reserved.
Figures
![Figure 1](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/2813992/bin/nihms104220f1.gif)
![Figure 2](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/2813992/bin/nihms104220f2.gif)
![Figure 3](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/2813992/bin/nihms104220f3.gif)
Similar articles
-
Epidemiology of systemic lupus erythematosus.Expert Rev Clin Immunol. 2017 Aug;13(8):799-814. doi: 10.1080/1744666X.2017.1327352. Epub 2017 May 16. Expert Rev Clin Immunol. 2017. PMID: 28471259 Review.
-
The effect of ethnicity and genetic ancestry on the epidemiology, clinical features and outcome of systemic lupus erythematosus.Rheumatology (Oxford). 2017 Apr 1;56(suppl_1):i67-i77. doi: 10.1093/rheumatology/kew399. Rheumatology (Oxford). 2017. PMID: 27940583 Review.
-
Epidemiology of systemic lupus erythematosus and cutaneous lupus erythematosus in a predominantly white population in the United States.Arthritis Care Res (Hoboken). 2015 May;67(6):817-28. doi: 10.1002/acr.22502. Arthritis Care Res (Hoboken). 2015. PMID: 25369985 Free PMC article.
-
The incidence and prevalence of systemic lupus erythematosus in the UK, 1999-2012.Ann Rheum Dis. 2016 Jan;75(1):136-41. doi: 10.1136/annrheumdis-2014-206334. Epub 2014 Sep 29. Ann Rheum Dis. 2016. PMID: 25265938 Free PMC article.
-
Systemic lupus erythematosus in a multiethnic US cohort (LUMINA): XXI. Disease activity, damage accrual, and vascular events in pre- and postmenopausal women.Arthritis Rheum. 2005 Jun;52(6):1655-64. doi: 10.1002/art.21048. Arthritis Rheum. 2005. PMID: 15934092
Cited by
-
Multiple Bilateral Retinal Pigment Epithelial Detachments in a Patient with Systemic Lupus Erythematosus: A Case Report.J Curr Ophthalmol. 2024 Mar 29;35(3):287-290. doi: 10.4103/joco.joco_267_22. eCollection 2023 Jul-Sep. J Curr Ophthalmol. 2024. PMID: 38681692 Free PMC article.
-
A Rare Case of Dual Metachronous Primary Malignancies, Chronic Myeloid Leukemia, and Tongue Carcinoma in a Patient With Long-Standing Systemic Lupus Erythematosus: A Case Report and Review of Literature.Cureus. 2024 Mar 21;16(3):e56648. doi: 10.7759/cureus.56648. eCollection 2024 Mar. Cureus. 2024. PMID: 38646281 Free PMC article.
-
Receipt of rheumatology care and lupus-specific labs among young adults with systemic lupus erythematosus: A US Medicare retention in care cohort study.Lupus. 2024 Jul;33(8):804-815. doi: 10.1177/09612033241247905. Epub 2024 Apr 17. Lupus. 2024. PMID: 38631342 Free PMC article.
-
Musculoskeletal symptoms in systemic lupus erythematosus patients and their impact on health-related quality of life.BMC Musculoskelet Disord. 2024 Apr 8;25(1):272. doi: 10.1186/s12891-024-07367-4. BMC Musculoskelet Disord. 2024. PMID: 38589834 Free PMC article.
-
An intersectionality framework for identifying relevant covariates in health equity research.Front Public Health. 2024 Mar 14;12:1286121. doi: 10.3389/fpubh.2024.1286121. eCollection 2024. Front Public Health. 2024. PMID: 38560446 Free PMC article. Review.
References
-
- Trager J, Ward MM. Mortality and causes of death in systemic lupus erythematosus. Curr Opin Rheumatol. 2001;13:345–51. - PubMed
-
- Alarcón GS. Of ethnicity, race and lupus. Lupus. 2001;10:594–6. - PubMed
-
- Huth EJ. Identifying ethnicity in medical papers. Ann Intern Med. 1995;122:619–21. - PubMed
-
- Fernandez M, Alarcón GS, Calvo-Alen J, Andrade R, McGwin G, Jr, Vila LM, et al. A multiethnic, multicenter cohort of patients with systemic lupus erythematosus (SLE) as a model for the study of ethnic disparities in SLE. Arthritis Rheum. 2007;57:576–84. - PubMed
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical