Mortality Among Minority Populations with Systemic Lupus Erythematosus, Including Asian and Hispanic/Latino Persons — California, 2007–2017

Gianfrancesco, Milena; Dall’Era, Maria; Helmick, Charles G.; Li, Jing; Rush, Stephanie; Trupin, Laura; Yazdany, Jinoos

doi:10.15585/mmwr.mm7007a2

Cited by 19 publications

(17 citation statements)

References 9 publications

(9 reference statements)

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“…Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can lead to severe clinical outcomes, with patients having higher rates of mortality when compared to the general population (1)(2)(3)(4). Despite improving trends in mortality, with the SLE mortality rate decreasing 2.7% every year from 1999 through 2013, overall mortality rates from SLE remain high (5).…”

Section: Introductionmentioning

confidence: 99%

“…Despite improving trends in mortality, with the SLE mortality rate decreasing 2.7% every year from 1999 through 2013, overall mortality rates from SLE remain high (5). For example, previous population-based studies have shown that individuals with SLE are 3 times more likely to die over a 10-year period than age-matched individuals in the general population (1)(2).…”

Section: Introductionmentioning

confidence: 99%

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Causes of Death Among Individuals With Systemic Lupus Erythematosus by Race and Ethnicity: A Population‐Based Study

Taylor

Anastasiou

et al. 2022

Arthritis Care & Research

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Objective Non‐White populations are at higher risk of developing systemic lupus erythematosus (SLE) and have more severe outcomes, including mortality. The present study was undertaken to examine how specific causes of death vary by race and ethnicity, including Asian and Hispanic individuals. Methods The California Lupus Surveillance Project included SLE cases identified among residents of San Francisco County, CA during January 1, 2007 to December 31, 2009. Cases were matched to the National Death Index over a 10‐year period. Logistic regression examined age‐adjusted differences in causes of death by race, ethnicity, and sex. Age‐standardized mortality ratios between individuals with SLE and the corresponding general population were calculated for the leading cause of death, and observed versus expected deaths were estimated. Results The study included 812 individuals of White (38%), Asian (36%), Black (20%), and mixed/other/unknown (5%) race; 15% identified as Hispanic. One hundred thirty‐five deaths were recorded, with a mean ± SD age at death of 62.2 ± 15.6 years. Cardiovascular disease (CVD) was the leading cause of death overall (33%), and across all racial and ethnic groups, followed by rheumatic disease (18%) and hematologic/oncologic conditions (18%). CVD as the underlying cause of death was 3.63 times higher among SLE cases than in the general population. CVD deaths for those with SLE were nearly 4 and 6 times higher for Asian and Hispanic individuals with SLE, respectively, compared to the general population. Conclusion Individuals with SLE experience a disproportionate burden of CVD mortality compared to the general population, which is magnified for Asian and Hispanic groups.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Causes of Death Among Individuals With Systemic Lupus Erythematosus by Race and Ethnicity: A Population‐Based Study

Taylor

Anastasiou

et al. 2022

Arthritis Care & Research

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“…A recent study showed that mortality in Latin population was four times higher than expected. (31) Lupus nephritis is the main SLE complication associated with death, as well as lupus nephritis patients are at high risk of developing ESRD. (32) In this way, management guidelines emphasize that the aims of treating lupus nephritis are to favor patients survival, to avoid flares and to preserve kidney function, among others.…”

Section: ❚ Resultsmentioning

confidence: 99%

Increase in direct costs for health systems due to lupus nephritis: the case of Colombia

Prada¹,

Pérez²,

Nieto-Aristizábal³

et al. 2022

Einstein (São Paulo)

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Objective: Lupus nephritis is one of the most severe complications of systemic lupus erythematosus and it has been estimated that can occur in up to 60% of patients. Direct costs of lupus nephritis have not been studied in developing countries. This study aimed to describe lupus nephritis direct costs in Colombia. Methods: Administrative data from two Colombian health maintenance organizations for 2014 and 2015 was obtained. An algorithm based on the International Statistical Classification of Diseases and Related Health Problems 10 th revision codes was developed to identify patients with lupus nephritis and lupus nephritis under study. Results:The average annual per-patient, all-claims, all-cause direct cost for lupus nephritis was US$ 12,624, 7.5 times higher than the average lupus patient without lupus nephritis. For lupus nephritis cases under study, estimated direct cost was US$ 3,664, 2 times higher than average lupus patient in Colombia. Difference in lupus nephritis patients is mainly accounted for the cost and frequency of procedures, exceeding by a factor of 5 the cost for durable medical equipment and the cost for drugs, respectively. Conclusion: Lupus patients who progress to lupus nephritis stage increased seven-fold the average annual per-patient, all-claims, and all-cause direct cost for the Colombian health system.

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“…Earlier investigations in the US during the 1960s and 1970s found marked disparities in SLE-related mortality among Asian or Pacific Islander SLE patients (28,29). More recent studies have found that overall Systemic Lupus International Collaborating Clinics/ACR Damage Index (SDI) scores and mortality are comparable to those in White patients with SLE (24,25,27,30). Nevertheless, studies on hospitalizations in California in the 1990s and the National Inpatient Sample database between 2006 and 2016 revealed elevated in-hospital mortality among Asian individuals with SLE as compared to White comparators (31,32).…”

Section: Discussionmentioning

confidence: 99%

Race, Ethnicity, and Disparities in the Risk of End‐Organ Lupus Manifestations Following a Systemic Lupus Erythematosus Diagnosis in a Multiethnic Cohort

Aguirre

Izadi

Trupin

et al. 2022

Arthritis Care & Research

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Objective Data on the onset of lupus manifestations across multiple organ domains and in diverse populations are limited. The objective was to analyze racial and ethnic differences in the risk of end‐organ lupus manifestations following systemic lupus erythematosus (SLE) diagnosis in a multiethnic cohort. Methods The California Lupus Epidemiology Study (CLUES) is a longitudinal study of SLE. Data on major end‐organ lupus manifestations were collected and categorized by organ system: renal, hematologic, neurologic, cardiovascular, and pulmonary. Multiorgan disease was defined as manifestations in ≥2 of these distinct organ systems. Kaplan‐Meier curves assessed end‐organ disease‐free survival, and Cox proportional hazards regression estimated the rate of end‐organ disease following SLE diagnosis, adjusting for age at diagnosis, sex, and self‐reported race and ethnicity (White, Hispanic, Black, and Asian). Results Of 326 participants, 89% were female; the mean age was 45 years. Self‐reported race and ethnicity were 30% White, 23% Hispanic, 11% Black, and 36% Asian. Multiorgan disease occurred in 29%. Compared to White participants, Hispanic and Asian participants had higher rates, respectively, of renal (hazard ratio [HR] 2.9 [95% confidence interval (95% CI) 1.8–4.7], HR 2.9 [95% CI 1.9–4.6]); hematologic (HR 2.7 [95% CI 1.3–5.7], HR 2.1 [95% CI 1.0–4.2]); and multiorgan disease (HR 3.3 [95% CI 1.8–5.9], HR 2.5 [95% CI 1.4–4.4]) following SLE diagnosis. Conclusion We found heightened risks of developing renal, hematologic, and multiorgan disease following SLE diagnosis among Hispanic and Asian patients with SLE, as well as a high burden of multiorgan disease among CLUES participants.

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Mortality Among Minority Populations with Systemic Lupus Erythematosus, Including Asian and Hispanic/Latino Persons — California, 2007–2017

Cited by 19 publications

References 9 publications

Causes of Death Among Individuals With Systemic Lupus Erythematosus by Race and Ethnicity: A Population‐Based Study

Causes of Death Among Individuals With Systemic Lupus Erythematosus by Race and Ethnicity: A Population‐Based Study

Increase in direct costs for health systems due to lupus nephritis: the case of Colombia

Race, Ethnicity, and Disparities in the Risk of End‐Organ Lupus Manifestations Following a Systemic Lupus Erythematosus Diagnosis in a Multiethnic Cohort

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