The Effect of Socioeconomic Status on Lupus Outcomes Save

Socioeconomic status (SES) often associates with poorer outcomes in systemic lupus erythematosus (SLE) patients; and a current study suggests this is unrelated to healthcare access issues.

A retrospective cohort of 617 adult SLE patients followed in tertiary medical centers were studied for outcomes including all-cause mortality, end-stage kidney disease (ESKD), and low disease activity score (≤ 4 SLEDAI 2K) at the last visit. Economic status was divided into a lower 25th quantile, middle 25th‐75th quantile, and upper 75th quantile.

These patients were largely femail (89%) followed for a median of 15 years. Compared to the middle and upper SES groups, the lower SES group had a:

• Younger age at disease onset
• Higher rate of lupus nephritis (42.7% vs. 35.7% and 23.8%, respectively, p = 0.002).
• Higher mortality (middle and upper SES groups had significantly lower mortality; HR = 0.45; 95% CI, 0.24–0.82, p = 0.010)
• Higher rates of ESKD (middle and upper SES groups had significantly less ESKD; HR = 0.24; 95% CI, 0.08–0.73, p = 0.012),
• Having SLEDAI 2K ≤ 4 had no effect on these outcomes (OR = 1.49; 95% CI, 0.92–2.40, p = 0.09).

Future healthcare interventions should focus on other possible barriers to obtaining optimal car in SLE patients of lower SES.