Study profiles mortality rates in SLE

Mortality rates from circulatory-related complications may be on the rise according to a large international cohort study of systemic lupus erythematosus (SLE) patients. However, the risk of death from other complications such as kidney disease is falling.To examine mortality rates in SLE, Dr Sasha Bernatsky (McGill University, Montreal) and colleagues assembled data from 9,547 patients from 23 international centres from 1970-2001.Deaths were ascertained by vital statistics registry linkage. Standardized mortality ratio (SMR; ratio of deaths observed to deaths expected) estimates were calculated for all deaths and by cause. The effects of sex, age, SLE duration, race, and calendar-year periods were determinedDr Bernatsky's group report that the overall SMR was 2.4 with a particularly high mortality observed for circulatory disease, infections, renal disease, non-Hodgkin's lymphoma, and lung cancer. Women, African Americans, younger patients and those with SLE for less than one year in duration were identified as those at higher risk of death than other groups.However, the authors report a dramatic decrease in total SMR estimates across calendar-year periods for some causes including death due to infections and death due to renal disorders.Dr Bernatsky comments, "We saw a decrease over time in the relative all-cause death rates, from 1970-1979, when SLE patients appeared to have a five-fold increased risk of death compared to the general population, to 1990-2001, when the increased risk of death for SLE patients was two-fold".Commenting on the increase in mortality from circulatory-related complications the authors highlight that traditional risk factors such as hypertension, obesity and inactivity, are prevalent in SLE and that some medications, in particular systemic corticosteroids, might also play a role.Reference...