Epidemiologic studies on systemic lupus erythematosus. Comparative data for New York City and Jefferson County, Alabama, 1956-1965.
TL;DR: A comparative population study on SLE from 1956–1965 revealed higher attack rates in New York City than in Jefferson County, Ala, and incidence, prevalence and mortality rates were approximately three times higher for Negro females than for whites.
Abstract: A comparative population study on SLE from 1956–1965 revealed higher attack rates in New York City than in Jefferson County, Ala. The difference was attributed to more complete case-finding in New York rather than to regional differences in predisposing factors. In both localities, incidence, prevalence and mortality rates were approximately three times higher for Negro females than for whites. In males, however, few cases were observed, and ethnic differences were considered equivocal.
Citations
More filters
TL;DR: After reviewing the medical literature for incidence and prevalence rates of 24 autoimmune diseases, it is concluded that many autoimmune diseases are infrequently studied by epidemiologists and the total burden of disease may be an underestimate.
1,519 citations
TL;DR: Data on SLE incidence and prevalence in the USA, Europe, Asia, and Australia over the period of 1950-early 2006 is summarized to clarify the role of genetic, environmental and other causative factors in the natural history of the disease, and to understand its clinical and societal consequences.
Abstract: Systemic lupus erythematosus (SLE) is a disease of multifactorial etiology. Quantifying the burden of SLE across different countries can clarify the role of genetic, environmental and other causative factors in the natural history of the disease, and to understand its clinical and societal consequences. The aim of this study is to summarize data on SLE incidence and prevalence in the USA, Europe, Asia, and Australia. An extensive review of electronic resources (PubMed and MedLine) and medical journals was conducted to identify published studies on SLE incidence and prevalence over the period of 1950-early 2006. Researchers in the countries of interest provided additional information on the epidemiology of SLE. The incidence and prevalence of SLE varies considerably across the countries. The burden of the disease is considerably elevated among non-white racial groups. There is a trend towards higher incidence and prevalence of SLE in Europe and Australia compared to the U.S.A. In Europe, the highest prevalence was reported in Sweden, Iceland and Spain. There are marked disparities in SLE rates worldwide. This variability may reflect true differences across populations, or result from methodological differences of studies. The true geographic, racial, and temporal differences in SLE incidence and prevalence may yield important clues to the etiology of disease.
771 citations
TL;DR: There are worldwide differences in the incidence and prevalence of SLE that vary with sex, age, ethnicity and time and further study of genetic and environmental risk factors may explain the reasons for these differences.
Abstract: Objectives The aim was to review the worldwide incidence and prevalence of SLE and variation with age, sex, ethnicity and time. Methods A systematic search of MEDLINE and EMBASE search engines was carried out using Medical Subject Headings and keyword search terms for Systemic Lupus Erythematosus combined with incidence, prevalence and epidemiology in August 2013 and updated in September 2016. Author, journal, year of publication, country, region, case-finding method, study period, number of incident or prevalent cases, incidence (per 100 000 person-years) or prevalence (per 100 000 persons) and age, sex or ethnic group-specific incidence or prevalence were collected. Results The highest estimates of incidence and prevalence of SLE were in North America [23.2/100 000 person-years (95% CI: 23.4, 24.0) and 241/100 000 people (95% CI: 130, 352), respectively]. The lowest incidences of SLE were reported in Africa and Ukraine (0.3/100 000 person-years), and the lowest prevalence was in Northern Australia (0 cases in a sample of 847 people). Women were more frequently affected than men for every age and ethnic group. Incidence peaked in middle adulthood and occurred later for men. People of Black ethnicity had the highest incidence and prevalence of SLE, whereas those with White ethnicity had the lowest incidence and prevalence. There appeared to be an increasing trend of SLE prevalence with time. Conclusion There are worldwide differences in the incidence and prevalence of SLE that vary with sex, age, ethnicity and time. Further study of genetic and environmental risk factors may explain the reasons for these differences. More epidemiological studies in Africa are warranted.
452 citations
TL;DR: The authors' rates clearly confirm previous reports of an excess incidence of SLE among females compared with males and among African-Americans compared with whites, and advocate their use to facilitate comparisons across studies.
Abstract: Objective. To examine racial differences in the incidence of systemic lupus erythematosus (SLE).
Methods. A population-based registry of SLE patients in Allegheny County, Pennsylvania, was used to identify incident cases of SLE diagnosed between January 1, 1985 and December 31, 1990, from 3 sources, by medical record review (University of Pittsburgh Lupus Databank, rheumatologists, and hospitals). Capture-recapture methods using log-linear models were used to estimate the level of case-finding and to calculate 95% confidence intervals (CI). Incidence rates were calculated per 100,000 population.
Results. A total of 191 definite and 78 probable incident cases of SLE were identified, and the overall annual incidence rates were 2.4 (95% CI 2.1–2.8) and 1.0 (95% CI 0.8–1.3), respectively. The crude incidence rates of definite SLE were 0.4 for white males, 3.5 for white females, 0.7 for African-American males, and 9.2 for African-American females. The annual incidence rates of definite SLE remained fairly constant over the study interval. African-American females with definite SLE had a younger mean age at diagnosis compared with white females (P < 0.05). Since the overall ascertainment rate was high (85%; 95% CI 78–92%), the ascertainment-corrected incidence rate for definite SLE, 2.8 (95% CI 2.6–3.2), was similar to the crude rate.
Conclusion. Our rates clearly confirm previous reports of an excess incidence of SLE among females compared with males and among African-Americans compared with whites. We have used capture–recapture methods to improve the accuracy of SLE incidence rates, and we advocate their use to facilitate comparisons across studies.
410 citations
TL;DR: Several clinical patterns of SLE were discerned: least common was the violent, rapidly fatal one; most patients experienced a benign, chronic course or intermittently stuttering illness; some had only one or a few brief episodes of the disease.
Abstract: The incidence, prevalence, and outcome of systemic lupus erythematosus (SLE) were examined in a large, well-defined population for which extensive records of complete medical care are available. The prevalence was 1:1,969; in women aged 15 to 64 years, approximately 1:700; in black women 15 to 64, 1:245. Mortality was low: only five deaths among 70 patients in whom SLE was freshly diagnosed occurred during an eightyear period. The projected ten-year survival rate exceeds 90%. The prevalence of clinically important renal disease was only 11%. Previous estimates of the prevalence of renal disease in SLE have been based on skewed series. Several clinical patterns of SLE were discerned: least common was the violent, rapidly fatal one; most patients experienced a benign, chronic course or intermittently stuttering illness; some had only one or a few brief episodes of the disease.
399 citations
References
More filters
48 citations
Journal Article•
25 citations