Background/Purpose: Marked regional variation in systemic lupus erythematosus (SLE) mortality may be due to different spectra of local environmental factors. There have been no large population-based studies of SLE mortality trends in Mexico. The aim of this study was to assess mortality trends in adults with SLE using a nationwide health registry.

Methods: Data came from the Dynamic Cubes of the General Direction of Health Information from 1998-2017 for mortality. In patients aged ≥ 15 years, SLE as the principal cause of death was defined according to the International Classification of Diseases (ICD)-10 code M32 and was classified by sex and age. Information was provided by the National Institute of Statistics, Geography and Informatics on mortality in the general population during the study period. Joinpoint trend analyses of annual age-standardized mortality rates (ASMR) (Table) for SLE patients and non-SLE people were carried out.

Results: From 1998 through 2017, we identified 11,449 SLE deaths and 9,911, 323 non-SLE deaths. The mean age of deaths for SLE was 37 years. The proportion of deaths among women was higher for SLE than for non-SLE. Over this period, SLE ASMR increased more than non-SLE ASMR, with a 53.8% cumulative increase in the ratio of SLE to non-SLE.

Whereas the non-SLE ASMR remained relatively stable throughout the 20 years (either overall or by sex), the SLE ASMR significantly increased between 1998 and 2008 (annual percentage change of 6.4 [95% CI 4.7 to 8.0]), decreased not significantly between 2008 and 2011 and not significantly increased there after. Similar pattern was seen for women with SLE and for men with SLE an increased between 2003 to 2017 was identified. Both women and men had large cumulative increase in the ratio of the SLE to the non-SLE ASMR (73.8% and 191.3%, respectively). Moreover, of the 11,449 deaths, 445 (3.8%) were in geographical areas where ≥ 40% of the population is indigenous, 6552 (57.6%) in areas with ≥ 5,000 indigenous inhabitants, and 4452 (38.6%) occurred in areas with no or very small indigenous inhabitants.

Conclusion: SLE mortality rates have increased since 1998 and remain high compared with non-SLE mortality: significant sex disparities persist.

The same method was used to calculate ASMR for all years from 1998 to 2017 and for all subpopulation based con sex.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/twenty-year-trends-in-systemic-lupus-erythematosus-all-cause-mortality-in-mexico-a-nationwide-health-registry/