Temporal Trends and Demographic Insights Into Mortality From Systemic Lupus Erythematosus, 1999-2020

Area of Science:

• Epidemiology
• Public Health
• Rheumatology

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with significant morbidity and mortality.
• Previous research indicated a decline in SLE mortality but highlighted persistent disparities.
• Understanding demographic and geographic trends in SLE mortality is crucial for targeted interventions.

Purpose of the Study:

• To analyze demographic characteristics associated with SLE deaths in the United States.
• To map national and geographic trends of SLE mortality over the past two decades (1999-2020).
• To identify specific populations and regions disproportionately affected by SLE mortality.

Main Methods:

• Utilized the CDC's Wide-Ranging Online Data for Epidemiologic Research (WONDER) database for SLE deaths from 1999 to 2020.
• Calculated age-adjusted mortality rates (AAMRs) stratified by sex, race/ethnicity, and state.
• Employed linear regression models to assess trends in SLE mortality rates and the ratio of SLE to non-SLE mortality.

Main Results:

• Identified 27,213 SLE deaths in the US between 1999 and 2020.
• Females and African Americans exhibited higher AAMRs compared to males and other racial/ethnic groups, particularly African American females.
• A significant decline in SLE AAMR was observed across all groups, with a sustained decrease in the SLE to non-SLE AAMR ratio; Southern states showed higher concentrations.

Conclusions:

• SLE-related mortality has decreased consistently since 1999 across diverse demographic segments.
• Disproportionately high SLE mortality rates persist among African Americans, especially women, and in Southern regions.
• Continued monitoring and targeted public health strategies are necessary to address persistent disparities in SLE outcomes.