Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov 1;63(11):3056-3064.
doi: 10.1093/rheumatology/kead617.

Multimorbidity in systemic lupus erythematosus in a population-based cohort: the Lupus Midwest Network

Gabriel Figueroa-Parra  1 , Jose A Meade-Aguilar  1 , Cassondra A Hulshizer  2 , Tina M Gunderson  2 , Alanna M Chamberlain  2   3 , Uma Thanarajasingam  1 , Kurt J Greenlund  4 , Kamil E Barbour  4 , Cynthia S Crowson  1   2 , Alí Duarte-García  1   5
Affiliations

Multimorbidity in systemic lupus erythematosus in a population-based cohort: the Lupus Midwest Network

Gabriel Figueroa-Parra et al. Rheumatology (Oxford). .

Abstract

Objectives: The objectives of this study were to assess the prevalence and incidence of multimorbidity and its association with the SLICC/ACR damage index (SDI) among patients with SLE.

Methods: Using prevalent and incident population-based cohorts of patients with SLE and their matched comparators, we assessed 57 chronic conditions. Chronic conditions were categorized as SDI-related or SDI-unrelated. Multimorbidity was defined as the presence of two or more chronic conditions. The prevalence of multimorbidity for both cohorts was compared using logistic regression. Cox models were used to examine the development of multimorbidity after SLE incidence.

Results: The prevalent cohort included 449 patients with established SLE on 1 January 2015. They were three times more likely to have multimorbidity compared with non-SLE comparators [odds ratio (OR) 2.98, 95% CI 2.18-4.11]. The incident cohort included 270 patients with new-onset SLE. At SLE incidence, patients with SLE were more likely to have multimorbidity than comparators (OR 2.27, 95% CI 1.59-3.27). After incidence, the risk of developing multimorbidity was 2-fold higher among patients with SLE than among comparators [hazard ratio (HR) 2.11, 95% CI 1.59-2.80]. The development of multimorbidity was higher in patients with SLE based on SDI-related conditions (HR 2.91, 95% CI 2.17-3.88) than on SDI-unrelated conditions (HR 1.73, 95% CI, 1.32-2.26).

Conclusion: Patients with SLE had a higher burden of multimorbidity, even before the onset of the disease. The risk disparity continued after SLE classification and was also seen in a prevalent SLE cohort. Multimorbidity was driven both by SDI-related and unrelated conditions.

Keywords: chronic disease; comorbidity; damage; epidemiology; multimorbidity; systemic lupus erythematosus.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Cumulative incidence of multimorbidity (≥2 chronic conditions) and substantial multimorbidity (≥5 chronic conditions), respectively, among patients with new-onset SLE (n = 116) and non-SLE comparators (n = 172), after excluding those with multimorbidity and substantial multimorbidity at SLE incidence date. The cumulative incidence is presented for all chronic conditions (Panel A), for chronic conditions related to the SLICC/ACR damage index (SDI) (Panel B), and for SDI-unrelated chronic conditions (Panel C)
See this image and copyright information in PMC

References

    1. Fanouriakis A, Tziolos N, Bertsias G, Boumpas DT. Update on the diagnosis and management of systemic lupus erythematosus. Ann Rheum Dis 2021;80:14–25. - PubMed
    1. Barber MRW, Drenkard C, Falasinnu T et al. Global epidemiology of systemic lupus erythematosus. Nat Rev Rheumatol 2021;17:515–32. - PMC - PubMed
    1. Arnaud L, Tektonidou MG. Long-term outcomes in systemic lupus erythematosus: trends over time and major contributors. Rheumatology (Oxford) 2020;59:v29–38. - PMC - PubMed
    1. Tektonidou MG, Lewandowski LB, Hu J, Dasgupta A, Ward MM. Survival in adults and children with systemic lupus erythematosus: a systematic review and Bayesian meta-analysis of studies from 1950 to 2016. Ann Rheum Dis 2017;76:2009–16. - PubMed
    1. Boyd CM, Fortin M. Future of multimorbidity research: how should understanding of multimorbidity inform health system design? Public Health Rev 2010;32:451–74.