Systemic lupus erythematosus epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2], Cafer Zorkun, M.D., Ph.D. [3], Raviteja Guddeti, M.B.B.S. [4]
Overview
Worldwide, the prevalence of systemic lupus erythematosus is 60 per 100,000 persons. In North America, South America, Europe, and Asia, the incidence of systemic lupus erythematosus ranges from as low as 1 per 100,000 persons to as high as 20 per 100,000 persons, with an average prevalence of 12 per 100,000 persons. The overall mortality rate of lupus is very high, estimated at approximately 50,000 deaths per 100,000. Women are more commonly affected with systemic lupus erythematosus than men. Systemic lupus erythematosus flare-ups are more prevalent in women. Systemic lupus erythematosus is more prevalent in people of the African and Asian races.
Epidemiology and Demographics
Prevalence
- Worldwide, the prevalence of systemic lupus erythematosus is 60 per 100,000 persons.[1]
- Worldwide, a conservative estimate suggests that over 5 million people have lupus.
- Throughout the United States, the prevalence of systemic lupus erythematosus ranges from a low of 20 per 100,000 persons to a high of 150 per 100,000 persons with an average prevalence of 25 per 100,000 persons.[1]
Incidence
- In North America, South America, Europe, and Asia, the incidence of systemic lupus erythematosus ranges from as low as 1 per 100,000 persons to as high as 20 per 100,000 persons, with an average prevalence of 12 per 100,000 persons.[1]
- Systemic lupus erythematosus incidence has approximately tripled during the past 3-4 decades. The increase in incidence is mainly attributed to improvement in diagnostic tests that have led to SLE diagnosis in earlier stages of the disease.
Case Fatality Rate
- The overall mortality rate of lupus is very high, estimated to have approximately 50,000 deaths per 100,000 cases.[1]
- Approximately one third of deaths from SLE occur among persons aged <45 years.
- Non-Causcasian race is a risk factor for death from SLE.
- SLE mortality is mainly due to associated organ failures related to long term or more severe disease manifestations include, secondary infection, end stage renal disease due to lupus nephritis, and cardiovascular disease from accelerated atherosclerosis.
Age
- The disease is more common in the young patient population even though it can occur at any age.
- Sixty-five percent of patients with SLE have disease onset between the ages of 16 and 55.
Gender
- Women are more commonly affected with systemic lupus erythematosus than men. Systemic lupus erythematosus flare ups are more prevalent in women.
- The female to male ratio is approximately 5 to 1.
- Men are more commonly affected with cutaneous lupus erythematosus than women.
- The male to female ratio is approximately 3 to 1.[2]
- Complications of SLE such as renal disease, skin manifestations, cytopenias, serositis, neurologic involvement, thrombosis, cardiovascular disease, hypertension, and vasculitis are more common in men than in women.
Race
- Systemic lupus erythematosus is more prevalent in Africans and Asians.
- The disease appears to be more common in urban than rural areas.
- Non-Caucasian race is a risk factor for death due to SLE.
- SLE is more severe among African-American women than others with a higher mortality rate.[1][3]