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‘Substantial’ Disparities in SLE Found Among Women in Manhattan
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Rates for prevalence, as well as incidence of systemic lupus erythematosus were about nine-times higher in women than men living in Manhattan, according to published results of the Manhattan Lupus Surveillance Program or MLSP, which is a population-based registry that focused on the prevalence and incidence of the condition in New York County (Manhattan), New York.
In other population-based findings from the study, there was a greater prevalence of systemic lupus erythematosus (SLE) among non-Hispanic black, Hispanic and non-Hispanic Asian women compared with non-Hispanic white women.
“To be honest, I think rheumatologists are well aware of lupus and who gets it. I think the take-home message overall is that data from the MLSP revealed substantial disparities in prevalence, incidence and manifestations of SLE by sex and race/ethnicity among residents,” Peter M. Izmirly, MD, MSc, assistant professor in the department of medicine and division of rheumatology at NYU Langone and co-principal investigator of the MLSP, told Healio Rheumatology.
The MLSP determined the incidence of SLE in 2007 among residents of Manhattan and the SLE incidence from 2007 to 2009 from hospital and rheumatologist records and administrative databases. All cases were identified using American College of Rheumatology (ACR) and SLICC classification criteria or were determined by the treating rheumatologist’s diagnosis. Investigators performed capture-recapture analyses to assess any case under-ascertainment and the rates of SLE among the residents studied were age-standardized.
Based on ACR definition, the per 100,000 person-year rates of age-standardized SLE prevalence and incidence were 62.2 and 4.6, respectively. For women vs. men, the SLE prevalence found was 107.4 and 12.5, respectively, and the SLE incidence found was 7.9 and 1, respectively.
Among the strengths of the study was its use of data analysis methods similar to those used in other CDC-funded SLE registries and, among CDC-funded SLE registries, the MLSP was the first to use the recently validated SLICC classification criteria for reporting.
“Women consistently had higher prevalence and incidence rates of SLE compared with men, and non-Hispanic blacks, Hispanics and non-Hispanic Asians had higher rates of diagnosed SLE and a higher proportion had lupus nephritis compared with non-Hispanic whites. The highest rates of SLE were seen among non-Hispanic black women, followed by Hispanic, non-Hispanic Asian, and non-Hispanic white women,” Izmirly said.
He said future plans include analyzing data from the MLSP to provide epidemiologic data for other related autoimmune disease, including Sjögren’s syndrome and mixed connective tissue disease. In addition, the CDC is working on using data from all five funded sites to provide incidence and prevalence estimates of SLE for the United States. – by Susan M. Rapp and Kristine Houck
Disclosure: The research was supported by cooperative agreements between the CDC and the New York City Department of Health and Mental Hygiene (grant U58/DP002827).
Editor’s note: The original story was updated on Sept. 14, 2017, to include additional comments from the researchers.
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Izmirly PM, et al. Arthritis Rheumatol. 2017;doi:10.1002/art.40192.
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