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Mortality in systemic lupus erythematosus.

S Bernatsky1, J-F Boivin, L Joseph

  • 1Montreal General Hospital, Montreal, Quebec, Canada.

Arthritis and Rheumatism
|July 27, 2006
PubMed
Summary

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This summary is machine-generated.

Systemic lupus erythematosus (SLE) patients face significantly higher mortality rates. While deaths from infections and renal disease have decreased, circulatory disease mortality remains a concern, especially for younger women and Black patients.

Area of Science:

  • Rheumatology
  • Epidemiology
  • Public Health

Background:

  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with significant morbidity and mortality.
  • Previous studies in smaller cohorts indicated increased mortality in SLE patients, but comprehensive data from large international cohorts were lacking.

Purpose of the Study:

  • To determine mortality rates in the largest systemic lupus erythematosus (SLE) cohort assembled to date.
  • To identify specific causes of death and risk factors associated with increased mortality in SLE patients.

Main Methods:

  • Analysis of a multisite international SLE cohort comprising 9,547 patients across 23 centers.
  • Mortality data ascertained through vital statistics registry linkage.
  • Calculation of standardized mortality ratios (SMRs) by cause, and assessment of effects of sex, age, SLE duration, race, and calendar-year periods.

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Main Results:

  • Overall standardized mortality ratio (SMR) was 2.4, indicating a 2.4-fold higher mortality in SLE patients compared to the general population.
  • High mortality rates were observed for circulatory diseases, infections, renal disease, non-Hodgkin's lymphoma, and lung cancer.
  • Increased mortality risk was associated with female sex, younger age, shorter SLE duration (<1 year), and Black/African American race.
  • A significant decrease in SMR for infections and renal disease was observed over calendar-year periods.
  • SMR for circulatory diseases showed a slight increase from the 1970s to 2001.

Conclusions:

  • This large international cohort confirms increased mortality in SLE patients.
  • Specific risk factors for mortality include female sex, younger age, shorter disease duration, and Black/African American race.
  • While lupus-related deaths (e.g., renal disease) have declined, circulatory disease mortality remains a significant concern and has not diminished over time.