Global epidemiology of systemic lupus erythematosus

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease with protean manifestations that predominantly affects young women. Certain ethnic groups are more vulnerable than others to developing SLE and experience increased morbidity and mortality. Reports of the global incidence and prevalence of SLE vary widely, owing to inherent variation in population demographics, environmental exposures and socioeconomic factors. Differences in study design and case definitions also contribute to inconsistent reporting. Very little is known about the incidence of SLE in Africa and Australasia. Identifying and remediating such gaps in epidemiology is critical to understanding the global burden of SLE and improving patient outcomes. Mortality from SLE is still two to three times higher than that of the general population. Internationally, the frequent causes of death for patients with SLE include infection and cardiovascular disease. Even without new therapies, mortality can potentially be mitigated with enhanced quality of care. This Review focuses primarily on the past 5 years of global epidemiological studies and discusses the regional incidence and prevalence of SLE and top causes of mortality.

Fig. 1 |. Global incidence estimates for SLE.

The figure shows the reported incidence ranges for systemic lupus erythematosus (SLE) per location (per 100,000 of the population), as denoted by the key. Not all data have been collected and reported uniformly across global regions. Precise overall prevalence ranges per region are outlined in TABLE 1, in which data for China mainland and Taiwan are listed independently. Nature Reviews Rheumatology remains neutral with regard to jurisdictional claims in published maps.

Fig. 2 |. Global prevalence estimates for SLE.

The figure shows the reported prevalence ranges for systemic lupus erythematosus (SLE) per location (per 100,000 of the population), as denoted by the key. Not all data have been collected and reported uniformly across global regions. Prevalence estimates seem much higher in Africa than in the rest of the world but are unlikely to reflect the true population prevalence, as these data are based on hospital and clinic samples. Precise overall prevalence ranges per region are outlined in TABLE 1, in which data for China mainland and Taiwan are listed independently. Nature Reviews Rheumatology remains neutral with regard to jurisdictional claims in published maps.