FINDINGS
While the mortality rate in the United States have declined over the past four decades, UCLA researchers found that the mortality rate for people with lupus has not declined as much as it has for the population overall.
The researchers found that among people with lupus, mortality rates are still higher for black people than for other ethnicities; rates for women are higher than those of men; and those in the South were higher than for other regions of the U.S. Mortality rates for people with lupus were affected by where they lived.
BACKGROUND
Lupus is a chronic disease in which the immune system attacks the body’s tissues and organs. The disease causes a telltale rash on the face, and symptoms include fatigue, fever and joint pain. More than 16,000 new cases are reported each year, according to the Lupus Foundation of America.
Although there is no cure for lupus, the 10-year survival rates improved dramatically from the 1950s, when they were only about 50 percent, to the 1980s, when they exceeded 90 percent. But the UCLA researchers sought a more comprehensive understanding of long-term trends in mortality for people with the disease.
METHOD
The researchers cross-referenced mortality statistics from the Centers for Disease Control and Prevention with population data from the U.S. Census Bureau from 1968 to 2013. They compared annual, age-standardized mortality rates between systemic lupus erythematous — the most common form of the disease — and all other causes. The scientists also examined data by demographic categories.
IMPACT
Understanding trends in mortality rates for people with lupus is important to ensuring equity in health care. The UCLA study could provide public health officials with information they can use to design interventions to address disparities in care.
Next, the researchers plan to examine causes of death among people with lupus across the same time period they analyzed in the current study. They will examine how long-term death rates are influenced by environmental factors, such as socioeconomic status and access to care, and by biological factors, such as genetics and epigenetics.
AUTHORS
Dr. Eric Yen, a clinical instructor in UCLA section of clinical immunology and allergy, is the study’s first author. Co-senior authors are Dr. Ram Raj Singh, a UCLA professor of medicine and pathology, and Dr. Arun Karlamangla, professor in residence in the UCLA division of geriatrics. Other authors are Dr. Magda Shaheen, Jennifer Woo, Neil Mercer, Ning Li and Dr. Deborah McCurdy, all of UCLA.
JOURNAL
The was published online Oct. 31 by the Annals of Internal Medicine.
FUNDING
The study was supported by the National Institutes of Health, the Lupus Foundation of America, the Rheumatology Research Foundation, the UCLA Children’s Discovery and Innovation Institute and the Mallinckrodt Research Fellowship Award.
