Systemic lupus erythematosus (SLE) is a leading cause of death among young women, according to an August 2018 study in Arthritis & Rheumatology.1 To help determine where SLE ranks among causes of death, Eric Y. Yen, MD, and Ram Raj Singh, MD, conducted a population-based study using nationwide mortality counts for all female residents of the U.S. from 2000 to 2015. They concluded that SLE is an important public health issue among young women and that ongoing research and education are needed to address it.
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Explore This IssueOctober 2018
“During my medical training in pediatrics, I noticed that lupus is a common disease that I see on the wards,” says Dr. Yen, assistant professor, Department of Medicine, University of California, Los Angeles (UCLA). “So when I joined the pediatric rheumatology fellowship at UCLA, I set out to determine SLE death rates.”
“To our dismay, we found the death rates for SLE were disproportionately high relative to death rates in the general population. … This finding led us to posit that SLE might be among the leading causes of death,” explains Dr. Singh, professor of medicine and pathology, and director of the Autoimmunity and Tolerance Laboratory, UCLA.
Previously, Drs. Yen and Singh, along with several others, conducted a multiple-regression analysis of SLE mortality risk stratified by race and ethnicity, which was published in the Annals of Internal Medicine in 2017. The analysis showed that SLE mortality risk was higher for women than men of all races and ethnicities, with the greatest differences among black and Hispanic patients.
Dr. Yen also noticed that SLE was not included in the 113 diseases on the Centers for Disease Control and Prevention’s (CDC’s) ranked list of leading causes of death. “Given my suspicion that SLE was more common than some of the other diseases on the CDC list, I decided to take on this project,” he says of the current research.
Study Methods & Results
Drs. Yen and Singh conducted a population-based study using nationwide mortality counts for U.S. girls and women. They obtained data on SLE deaths from the CDC Wide-Ranging Online Data for Epidemiologic Research (WONDER) database. They attributed deaths to SLE if codes from the International Classification of Diseases, 10th revision (ICD-10), for SLE were listed as an underlying or contributing cause of death on the death certificate: M32.1, SLE with organ or system involvement; M32.8, other forms of SLE; and M32.9, SLE, unspecified.