This article is more than 5 years old. Information may no longer be current.

Lupus mortality rates remain high, despite improving trends

Mortality rates from systemic lupus erythematosus have declined since 1968 but remain disproportionately high relative to non-lupus mortality; in addition, significant disparities among subpopulations and geographic regions persist, according to findings published in Annals of Internal Medicine.

“Systemic lupus erythematosus is a chronic autoimmune disease with limited treatment options,” Eric Y. Yen, MD, MS, from the University of California, Los Angeles, and colleagues wrote. “Five- and 10-year survival rates for patients with [lupus] improved from less than 50% in the 1950s to more than 90% in the 1980s. However, the influence of more recent diagnostic and therapeutic developments on [lupus] mortality in the general population of the United States is unknown.”

Yen and colleagues performed a population-based study using a national mortality database and census data to determine the temporal trends and population characteristics of lupus mortality from 1968 to 2013. The researchers assessed the annual age-standardized mortality rates for lupus and non-lupus causes by sex, race/ethnicity and geographic region using joinpoint trend analysis. They also conducted multiple logistic regression analysis to evaluate which demographic variables were independently associated with lupus mortality.

The researchers identified 50,249 deaths attributable to lupus and 100,851,288 deaths due to other causes during the 46-year study period. Mortality rates for lupus decreased less than non-lupus mortality rates, with a 34.6% higher ratio of lupus to non-lupus mortality from 1968 to 2013. Mortality rates for causes other than lupus decreased annually since 1968, while mortality rates for lupus declined from 1968 to 1975, increased from 1975 to 1999, then declined again from 1999 to 2013.

The researchers found that among subpopulations, there were significant differences in lupus mortality. Lupus mortality rates were higher and increases in the ratio of lupus to non-lupus mortality rates were greater in females (31.4%), blacks (62.5%) and those living in the South (58.6%). Older individuals, Hispanics and residents of the West also had higher mortality rates. Whites did not experience statistically significant increases in lupus mortality rates.

Lupus mortality differed depending on region of residence among individuals of the same race/ethnicity, the researchers noted.

Sex, race and region were independently associated with lupus mortality, according to multiple logistic regression.

“Despite improving trends, [lupus] mortality remains high relative to non-[lupus] mortality, and disparities persist between subpopulations and geographic regions,” Yen and colleagues concluded.

“Comprehensive examination of [lupus] mortality using prospective population-based data collection could be helpful in understanding the mechanisms of the disparities in [lupus] mortality and identifying potentially modifiable risk factors that might inform targeted research and public health programs to promote health equity across subpopulations and regions of the United States,” they added. – by Alaina Tedesco

Disclosure: The authors report no relevant financial disclosures.