Long-Term Outcome in Systemic Lupus Erythematosus; Knowledge from Population-Based Cohorts.

Sigrid Reppe Moe,Øyvind Molberg,Hilde Haukeland,Karoline Lerang

doi:10.3390/jcm10194306

Abstract

Background: Accurate knowledge of outcomes in Systemic Lupus Erythematosus (SLE) is crucial to understanding the true burden of the disease. The main objective of this systematic review was to gather all population-based studies on mortality, end-stage renal disease (ESRD) and cancer in SLE. Method: We performed a systematic literature search in two electronic databases (MEDLINE and Embase) to identify all population-based articles on SLE and survival, mortality, ESRD and cancer. The SLE diagnosis had to be verified. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). Results: We included 40/1041 articles on mortality (27), ESRD (11) and cancer (3), of which six were defined as inception studies. In the total SLE cohort, the standardized mortality ratio ranged from 1.9 to 4.6. Cardiovascular disease was the most frequent cause of death in studies with follow-up times over 15 years. SLE progressed to ESRD in 5–11% of all SLE patients. There are no data supporting increased cancer incidence from population-based inception cohorts. Conclusion: There is a need for more population-based studies on outcomes of SLE, especially inception studies, with the use of control groups and follow-up times over 15 years.

Highlights

Systemic Lupus Erythematosus (SLE) is a rare systemic and chronic disease often referred to as the prototype of autoimmune rheumatic diseases because of the varied spectrum of clinical manifestations and diversity of phenotypes
The objective of this study was to conduct a review of literature on population-based epidemiologic data on SLE and well-defined and hard outcomes; mortality, end-stage renal disease (ESRD) and cancer
We identified 40 studies that met the criteria for inclusion, whereof 27 were for survival and mortality, 11 were and threewere werefor forcancer cancer(Figure (Figure1)

Summary

Introduction

Systemic Lupus Erythematosus (SLE) is a rare systemic and chronic disease often referred to as the prototype of autoimmune rheumatic diseases because of the varied spectrum of clinical manifestations and diversity of phenotypes. Several aspects of SLE make it one of the most challenging conditions to study at the population level. The main objective of this systematic review was to gather all population-based studies on mortality, end-stage renal disease (ESRD) and cancer in SLE. Method: We performed a systematic literature search in two electronic databases (MEDLINE and Embase) to identify all population-based articles on SLE and survival, mortality, ESRD and cancer. Results: We included 40/1041 articles on mortality (27), ESRD (11) and cancer (3), of which six were defined as inception studies. There are no data supporting increased cancer incidence from population-based inception cohorts. Conclusion: There is a need for more population-based studies on outcomes of SLE, especially inception studies, with the use of control groups and follow-up times over 15 years

Objectives

Methods

Conclusion