Global epidemiology of systemic lupus erythematosus: a comprehensive systematic analysis and modelling study

Abstract

Objectives: To quantify global, regional and country-specific estimates of epidemiology of systemic lupus erythematosus (SLE).

Methods: Four databases were systematically searched, and a Bayesian hierarchical linear mixed model was constructed to estimate the global, regional, and country-specific incidence and prevalence of SLE.

Results: 112 studies met the inclusion criteria. The global SLE incidence and newly diagnosed population were estimated to be 5.14 (1.4 to 15.13) per 100 000 person-years and 0.40 million people annually, respectively. In women, the values were 8.82 (2.4 to 25.99) per 100 000 person-years and 0.34 million people annually, while in men, the estimates were 1.53 (0.41 to 4.46) per 100 000 person-years and 0.06 million people annually, respectively. Poland, the USA and Barbados had the highest estimates of SLE incidence. Regarding prevalence, the global SLE prevalence and affected population were estimated to be 43.7 (15.87 to 108.92) per 100 000 persons and 3.41 million people, respectively. In women, the values were 78.73 (28.61 to 196.33) per 100 000 persons and 3.04 million people, while in men the estimates were 9.26 (3.36 to 22.97) per 100 000 persons and 0.36 million people, respectively. The United Arab Emirates, Barbados and Brazil had the highest SLE prevalence. In addition to regional and sex differences, age and prevalence estimation method (period or point prevalence) differences could also lead to variations in epidemiological SLE findings.

Conclusions: Epidemiological data on SLE are lacking for 79.8% of countries worldwide. The epidemiology of SLE varies substantially between different sex and age groups and is distributed unequally among geographical regions; specifically, SLE occurs more frequently in high-income countries.

Keywords: Autoimmune Diseases; Epidemiology; Systemic Lupus Erythematosus.

Figure 1

Distribution of number of studies included in statistical analysis by country. Countries with no observed data are white.

Figure 2

Incidence of systemic lupus erythematosus for overall population by country.

Figure 3

(A) Crude incidence of SLE in female according to world regions. (B) Crude incidence of SLE in male according to world regions. SLE, systemic lupus erythematosus.

Figure 4

One-year period (physician or dermatologist diagnosed) prevalence of systemic lupus erythematosus for overall population by country.

Figure 5

(A) Crude 1-year period (physician or dermatologist diagnosed) prevalence of SLE in female according to world regions. (B) Crude 1-year period (physician or dermatologist diagnosed) prevalence of SLE in male according to world regions. SLE, systemic lupus erythematosus.