Population-based incidence and time to classification of systemic lupus erythematosus by three different classification criteria: a Lupus Midwest Network (LUMEN) study

Duarte‐García, Alí; Hocaoğlu, Mehmet; Osei‐Onomah, Shirley‐Ann; Dabit, Jesse Y.; Giblon, Rachel; Helmick, Charles G.; Crowson, Cynthia S.

doi:10.1093/rheumatology/keab807

Cited by 16 publications

(18 citation statements)

References 23 publications

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“…The analysis of their use in the years 2000–2015 revealed stable increases. Interestingly, at the same time, the incidence of SLE showed a similar trend [ 10 ] ( Figure 1 ). Immunosuppressive treatment of LN may additionally contribute to dysbiosis.…”

Section: Introductionmentioning

confidence: 68%

Lupus Nephritis and Dysbiosis

2023

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Lupus nephritis (LN) is one of the most common and serious complications of systemic lupus erythematosus (SLE). The risk factors for developing LN by SLE patients are not fully understood. They are considered to be a mix of genetic and environmental variables, one of them being dysbiosis, proposed recently to interfere with autoimmunity. As of yet, the relations between the human microbiome, its genetic determinants, individual variability and clinical consequences remain to be established. One of the major obstacles in studying them is the magnitude of confounders, such as diet, drugs, infections or antibiotics use. They also make comparison between the studies extremely complicated. We reviewed the available evidence for the interplay between microbiome, dysbiosis and mechanisms triggering the autoimmune responses and potentially contributing to LN development. One such mechanism is the stimulation of autoimmune responses by bacterial metabolites that can mimic autoantigens and cause antibody production. These mimicking microbial antigens seem to be a promising target for future interventions.

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Section: Introductionmentioning

confidence: 68%

Lupus Nephritis and Dysbiosis

2023

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“…Data from all patients meeting EULAR/ACR criteria for SLE from 1976 to 2018 living within these 8 counties in Minnesota were collected. The EULAR/ACR criteria were selected as the primary definition due to their better performance classifying patients in epidemiologic studies than the other commonly used SLE classification criteria (12). The ACR criteria from 1997 (ACR 97) were used as a secondary definition for comparison purposes (14).…”

Section: Methodsmentioning

confidence: 99%

“…Given the lack of population-based studies evaluating childhood-onset SLE epidemiology, we aimed to characterize the incidence (from 1976 to 2018) and the prevalence of childhood-onset SLE and to estimate the proportion of patients who are diagnosed with SLE during childhood leveraging the resources of a record-linkage system, which minimizes misclassification and misdiagnosis. In addition, we used the novel and rigorously developed European League Against Rheumatism/ American College of Rheumatology (EULAR/ACR) SLE classification criteria (11), which classify more patients in epidemiologic studies compared to older criteria (12).…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Childhood‐Onset Systemic Lupus Erythematosus: A Population‐Based Study

Valenzuela‐Almada

Hocaoğlu

Dabit

et al. 2022

Arthritis Care & Research

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Objective. To characterize the incidence and prevalence of childhood-onset systemic lupus erythematosus (SLE), and to estimate the proportion of patients who are diagnosed with SLE during childhood.Methods. A cohort of patients with incident childhood-onset SLE from 1976 to 2018 from an 8-county region in the US were identified based on comprehensive medical record review. All patients met the European Alliance of Associations for Rheumatology (EULAR)/American College of Rheumatology (ACR) classification criteria for SLE or the ACR SLE classification criteria from 1997 at or before age 18 years. Incidence rates were estimated using Poisson methods. We estimated the childhood-onset SLE point prevalence for January 1, 2015. Results were sex and age adjusted to the US 2000 population. Among all the SLE patients living in the 8-county region on January 1, 2015, the proportion of patients diagnosed at ≤18 years was estimated.Results. A total of 13 children were diagnosed with childhood-onset SLE during the study period (using the EULAR/ ACR definition; mean age at diagnosis 15.1 years, 85% female, 69% White). Childhood-onset SLE overall adjusted incidence rate was 0.7 (95% confidence interval [95% CI] 0.2-1.1) per 100,000 children. The incidence rate in girls was 1.2 (95% CI 0.5-1.9) per 100,000 children, while in boys it was 0.2 (95% CI 0.0-0.5) per 100,000. The adjusted prevalence of childhood-onset SLE was 1.1 (95% CI 0.0-3.1) per 100,000 children. The proportion of patients with SLE diagnosed as children was 9% (95% CI 6-13%). Conclusion.In this population-based study, both the incidence and prevalence rates of childhood-onset SLE were ~1 per 100,000 children. One in 10 adults with SLE was diagnosed in childhood. More studies are needed to further characterize the epidemiology of childhood-onset SLE in minorities.

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“…There were no significant improvements in mortality rate, with a standardized mortality ratio (SMR) of 1.8 (95% CI 1.0, 3.0) from 1977–1988 for SLE patients compared with the general population and 2.9 (95% CI 1.4, 5.2) from 2009–2018 [ 14 ]. The Olmsted CDC registry was also recently used to compare incidence and time to classification between all three commonly used SLE classification criteria, demonstrating that incidence varies substantially depending on the SLE classification criteria that are employed [ 16 ]. The highest age- and sex-adjusted incidence was obtained when 2019 EULAR/ACR classification criteria were used [4.5 per 100 000 population (95% CI 3.7, 5.2)].…”

Section: Recent Updates In the Global Burden Of Slementioning

confidence: 99%

“…Incidence was lower when SLE was classified according to 2012 SLICC classification criteria [ 17 ] [4.0 per 100 000 (95% CI 3.3, 4.7)] or 1997 ACR classification criteria [ 18 ] [3.3 per 100 000 (95% CI 2.6, 3.9)]. The 2019 EULAR/ACR criteria also provided the earliest time to disease classification with a median time of 29.4 months from first disease manifestation to formal SLE classification ( vs 47.0 months using 1997 ACR criteria and 30.6 months for 2012 SLICC criteria) [ 16 ].…”

Section: Recent Updates In the Global Burden Of Slementioning

confidence: 99%

The global epidemiology of SLE: narrowing the knowledge gaps

et al. 2023

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SLE is a global health concern that unevenly affects certain ethnic/racial groups. Individuals of Asian, Black, Hispanic and Indigenous ethnicity/race are amongst those who experience increased prevalence, incidence, morbidity and mortality. Population-based surveillance studies from many regions are few and often still in nascent stages. Many of these areas are challenged by restricted access to diagnostics and therapeutics. Without accurately capturing the worldwide burden and distribution of SLE, appropriately dedicating resources to improve global SLE outcomes may be challenging. This review discusses recent SLE epidemiological studies, highlighting the challenges and emerging opportunities in low- and middle-income countries. We suggest means of closing these gaps to better address the global health need in SLE.

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Population-based incidence and time to classification of systemic lupus erythematosus by three different classification criteria: a Lupus Midwest Network (LUMEN) study

Cited by 16 publications

References 23 publications

Lupus Nephritis and Dysbiosis

Lupus Nephritis and Dysbiosis

Epidemiology of Childhood‐Onset Systemic Lupus Erythematosus: A Population‐Based Study

The global epidemiology of SLE: narrowing the knowledge gaps

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