Mortality in systemic lupus erythematosus.

By S. Bernatsky, J. Boivin, Lawrence Joseph, S. Manzi, Ellen M. Ginzler, D. Gladman, M. Urowitz, P. Fortin, Michelle A Petri, S. Barr and 23 more. Arthritis & Rheumatism, 2006

619 citations recorded by the source corpus.

OBJECTIVE To examine mortality rates in the largest systemic lupus erythematosus (SLE) cohort ever assembled. METHODS Our sample was a multisite international SLE cohort (23 centers, 9,547 patients). Deaths were ascertained by vital statistics registry linkage. Standardized mortality ratio (SMR; ratio of deaths observed to deaths expected) estimates were calculated for all deaths and by cause. The effects of sex, age, SLE duration, race, and calendar-year periods were determined. RESULTS The overall SMR was 2.4 (95% confidence interval 2.3-2.5). Particularly high mortality was seen for circulatory disease, infections, renal disease, non-Hodgkin's lymphoma, and lung cancer. The highest SMR estimates were seen in patient groups characterized by female sex, younger age, SLE duration <1 year, or black/African American race. There was a dramatic decrease in total SMR estimates across calendar-year periods, which was demonstrable for specific causes including death due to infections and death due to renal disorders. However, the SMR due to circulatory diseases tended to increase slightly from the 1970s to the year 2001. CONCLUSION Our data from a very large multicenter international cohort emphasize what has been demonstrated previously in smaller samples. These results highlight the increased mortality rate in SLE patients compared with the general population, and they suggest particular risk associated with female sex, younger age, shorter SLE duration, and black/African American race. The risk for certain types of deaths, primarily related to lupus activity (such as renal disease), has decreased over time, while the risk for deaths due to circulatory disease does not appear to have diminished.

Subfields: Epidemiology, Rheumatology

View Paper: https://www.semanticscholar.org/paper/f476a58815ba9e320cc2a63fa7a876832505b3fa

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Citations in the corpus

American College of Rheumatology Guidelines for Screening, Case Definition, Treatment and Management of Lupus Nephritis (2012, background): “Standardized incidence rates for end-stage renal disease in the US have risen for younger patients, among African Americans, and in the South (79).”
Personalized Immunomonitoring Uncovers Molecular Networks That Stratify Lupus Patients (2016, neutral): “SLE is primarily managed with hydroxychloroquine (HC), corticosteroids, and immunosuppressive agents, such as myco- phenolate mofetil (MMF) and cyclophosphamide (Bernatsky et al., 2006).”