Monday, 20 May 2019

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Racial Disparities in Mortality Associated with Systemic Lupus Erythematosus

A Morbidity and Mortality Weekly Report on a registry of systemic lupus erythematosus (SLE) patients from two Georgia counties (Fulton and Dekalb) shows SLE mortality was 2-3 times higher compared to the general population, especially amongst blacks; notably deaths occurred sooner after diagnosis and at a mean age approximately 13 years younger.

In lupus the 5-year survival rates have risen from 50% in 1955 to approximately 90% in the 2000s, yet there remains a significant risk for premature mortality in SLE patients.

SLE mortality was analyzed using 2002–2004 data from the population-based Georgia Lupus Registry. Among 97 incident and prevalent SLE cases they identified 97 and 401 deaths, respectively. Adjusted standardized mortality ratios were 2.3–3.3 times higher for persons with prevalent SLE relative to expected deaths in the general population.

Thus, blacks had significantly higher cumulative mortality than did whites. Black females with prevalent SLE were three times more likely to die than were black females in the general population (standardized mortality ratio = 3.38). Moreover, blacks were more likely to die at a younger age(mean age 51.8 and 52.3 years, respectively) than whites (mean 64.4 and 65.0 years, respectively).

Despite increasing awareness of SLE and advancements in treatment, mortality among persons with SLE remains high, with the highest standardized mortality ratio among black females. The effect of this racial disparity in mortality is further underscored by the fact that the prevalence of SLE in blacks is three times that in whites.

The report outlines several efforts to identify and prioritize reversible mortality factors and strategies to address these racial disparities and improve overall SLE outcomes. 

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