Tags

Type your tag names separated by a space and hit enter

Understanding the epidemiology and progression of systemic lupus erythematosus.

Abstract

OBJECTIVES

This review examines the burden and patterns of disease in systemic lupus erythematosus (SLE) and the influence and interactions of gender, ethnicity, age, and psychosocial attributes with respect to disease progression, focusing on issues relevant to clinical practice and research.

METHODS

PubMed literature search complemented by review of bibliographies listed in identified articles.

RESULTS

An increased risk among reproductive age women is clearly seen in African Americans in the United States. However, in other populations, a different pattern is generally seen, with the highest age-specific incidence rates occurring in women after age 40 years. The disease is 2 to 4 times more frequent, and more severe, among nonwhite populations around the world and tends to be more severe in men and in pediatric and late-onset lupus. SLE patients now experience a higher than 90% survival rate at 5 years. The less favorable survival experience of ethnic minorities is possibly related to socioeconomic status rather than to ethnicity per se, and adequate social support has been shown to be a protective factor, in general, in SLE patients. Discordance between physician and patient ratings of disease activity may affect quality of care.

CONCLUSIONS

Our understanding of ways to improve outcomes in SLE patients could benefit from patient-oriented research focusing on many dimensions of disease burden. Promising research initiatives include the inclusion of community-based patients in longitudinal studies, use of self-assessment tools for rating disease damage and activity, and a focus on self-perceived disease activity and treatment compliance.

Links

  • PMC Free PDF
  • PMC Free Full Text
  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Division of Clinical Immunology and Rheumatology, The University of Alabama at Birmingham, Birmingham, AL, USA.

    , , ,

    Source

    Seminars in arthritis and rheumatism 39:4 2010 Feb pg 257-68

    MeSH

    African Americans
    Age Factors
    Age of Onset
    Disease Progression
    Female
    Humans
    Incidence
    Lupus Erythematosus, Systemic
    Male
    Prevalence
    Sex Factors
    United States

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Review

    Language

    eng

    PubMed ID

    19136143

    Citation

    Pons-Estel, Guillermo J., et al. "Understanding the Epidemiology and Progression of Systemic Lupus Erythematosus." Seminars in Arthritis and Rheumatism, vol. 39, no. 4, 2010, pp. 257-68.
    Pons-Estel GJ, Alarcón GS, Scofield L, et al. Understanding the epidemiology and progression of systemic lupus erythematosus. Semin Arthritis Rheum. 2010;39(4):257-68.
    Pons-Estel, G. J., Alarcón, G. S., Scofield, L., Reinlib, L., & Cooper, G. S. (2010). Understanding the epidemiology and progression of systemic lupus erythematosus. Seminars in Arthritis and Rheumatism, 39(4), pp. 257-68. doi:10.1016/j.semarthrit.2008.10.007.
    Pons-Estel GJ, et al. Understanding the Epidemiology and Progression of Systemic Lupus Erythematosus. Semin Arthritis Rheum. 2010;39(4):257-68. PubMed PMID: 19136143.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Understanding the epidemiology and progression of systemic lupus erythematosus. AU - Pons-Estel,Guillermo J, AU - Alarcón,Graciela S, AU - Scofield,Lacie, AU - Reinlib,Leslie, AU - Cooper,Glinda S, Y1 - 2009/01/10/ PY - 2008/07/10/received PY - 2008/09/26/revised PY - 2008/10/18/accepted PY - 2009/1/13/entrez PY - 2009/1/13/pubmed PY - 2010/4/20/medline SP - 257 EP - 68 JF - Seminars in arthritis and rheumatism JO - Semin. Arthritis Rheum. VL - 39 IS - 4 N2 - OBJECTIVES: This review examines the burden and patterns of disease in systemic lupus erythematosus (SLE) and the influence and interactions of gender, ethnicity, age, and psychosocial attributes with respect to disease progression, focusing on issues relevant to clinical practice and research. METHODS: PubMed literature search complemented by review of bibliographies listed in identified articles. RESULTS: An increased risk among reproductive age women is clearly seen in African Americans in the United States. However, in other populations, a different pattern is generally seen, with the highest age-specific incidence rates occurring in women after age 40 years. The disease is 2 to 4 times more frequent, and more severe, among nonwhite populations around the world and tends to be more severe in men and in pediatric and late-onset lupus. SLE patients now experience a higher than 90% survival rate at 5 years. The less favorable survival experience of ethnic minorities is possibly related to socioeconomic status rather than to ethnicity per se, and adequate social support has been shown to be a protective factor, in general, in SLE patients. Discordance between physician and patient ratings of disease activity may affect quality of care. CONCLUSIONS: Our understanding of ways to improve outcomes in SLE patients could benefit from patient-oriented research focusing on many dimensions of disease burden. Promising research initiatives include the inclusion of community-based patients in longitudinal studies, use of self-assessment tools for rating disease damage and activity, and a focus on self-perceived disease activity and treatment compliance. SN - 1532-866X UR - https://www.unboundmedicine.com/medline/citation/19136143/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0049-0172(08)00197-2 DB - PRIME DP - Unbound Medicine ER -