Thomas Bartow, MD, FACP, is clinical lead in rheumatology at the Marshfield Clinic Health System in Marshfield, Wis. He notes the study was well done for the question it asked.
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“This study is a very imaginative way to ask the very basic question of whether we are doing better in keeping SLE patients alive,” says Dr. Bartow, who was not involved in the study. “It is a very fundamental question to ask, and I think they went about getting their answer in a very ambitious way, going all the way back to 1968.”
Although he notes the increase in deaths from 1975–1999, he thinks this may be less of an indicator of treatment and more of an indicator of case finding. He points out that the time of the bump in death rates was about the time improvements in lab testing began impacting diagnosis. These advances may also explain the lowering of death rates from 1999 forward.
“From the clinician’s viewpoint, it is [now] much easier to diagnose lupus earlier, and this means we are seeing patients with much milder disease than before, but on the other hand, we are seeing more of them,” Dr. Bartow says. “The encouraging thing is, we are doing better. The death rate is going down, so I think we are on the right track.”
Kurt Ullman has been a freelance writer for more than 30 years and a contributing writer to The Rheumatologist for 10 years.
- Yen EY, Shaheen M, Woo JMP, et al. 46-Year trends in systemic lupus erythematosus mortality in the United States, 1968 to 2013: A nationwide population-based study. Ann Intern Med. 2017 Dec 5;167(11):777–785.