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A longitudinal study of systemic lupus erythematosus (SLE) from the Toronto Lupus Clinic has shown that mortality has decreased over time.
The cohort incuded 1732 SLE patients followed between 1971 and 2013. The cause of death was gleaned from death certificates, autopsy reports, hospital records or the records of the family physicians.
The all-cause and cause-specific SMR was particularly high for younger patients, but has improved substantially in the last 50 years. The aim of the present study was to assess the evolution of the all-cause, cause-specific and age-specific standardised mortality ratios (SMRs) of patients with lupus in Ontario, Canada.
Between 1971 and 2013, 249 SLE patients died from either infections (24.5%), atherosclerosis (15.7%), active lupus (13.3%), or malignancy (9.6%).
The all-cause standardised mortality ratios (SMR) decreased from 13.5 the 1970s to 2.2 in recent years. The same temporal trends were observed for atherosclerosis, infections and malignancies.
Younger patients (19–39 years) had a higher SMR (SMR=12.4, 95% CI 9.7 to 15.1) as compared with individuals older than 40 years (SMR=3.1, 95% CI 2.6 to 3.6).
Lupus survival has improved over time, reflecting the advances in management of SLE and its comorbidities.