Overall and cause-specific mortality in systemic lupus erythematosus: an updated meta-analysis

Area of Science:

• Rheumatology and Immunology
• Epidemiology
• Public Health

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with significant morbidity and mortality.
• Understanding the specific mortality risks associated with SLE is crucial for improving patient outcomes and healthcare strategies.

Purpose of the Study:

• To conduct a meta-analysis assessing all-cause and cause-specific standardized mortality ratios (SMRs) in patients with SLE compared to the general population.
• To investigate sex-specific, ethnicity-specific, and cause-specific mortality patterns in SLE.

Main Methods:

• Systematic literature search of PubMed, EMBASE, and Cochrane databases, supplemented by manual searches.
• Meta-analysis of standardized mortality ratios (SMRs) for all-cause, sex-specific, ethnicity-specific, and cause-specific mortality in SLE patients.

Main Results:

• Fifteen studies including 26,101 SLE patients revealed a 2.6-fold increased all-cause SMR (SMR 2.663).
• Elevated SMRs were observed across ethnicities (Caucasians: 2.721, Asians: 2.587) and sexes (Women: 3.141, Men: 3.516).
• Significantly increased mortality risks were found for renal disease (SMR 4.689), cardiovascular disease (CVD) (SMR 2.253), and infection (SMR 4.980), but not for cancer (SMR 1.163).

Conclusions:

• Patients with SLE exhibit substantially higher all-cause mortality rates compared to the general population.
• Mortality risk is elevated across different sexes, ethnicities, and specific causes including renal disease, CVD, and infections.
• The study found no significant increase in cancer-related mortality among SLE patients.