Background/Purpose: Advancements in immunosuppressive treatments and general medical care in the past two decades have influenced the disease burden and outcomes of patients with systemic lupus erythematosus (SLE). This study aimed to provide an up-to-date analysis on the prevalence, incidence, and mortality in the present era of SLE management.

Methods: We established a large retrospective cohort of SLE patients using the Clinical Data Analysis and Reporting System (CDARS, an territory-wide electronic health records system managed by the Hospital Authority of Hong Kong) between 1995 to 2024. The incidence, prevalence and all-cause mortality were evaluated between 2005 and 2024, and age-standardization was based on the WHO 2000–2025 standard population (SEER datasets). The change of trends was assessed by the estimated annual percentage change (EAPC).

Results: 8,545 incident cases were observed between 2005 and 2024, with a prevalence of 10,582 in 2024. Crude prevalence (per 100,000 persons) of SLE increased from 65.3 to 140.6 [EAPC: 4.1 (3.8 to 4.4)], and prevalence rates for female and male were 234.8 and 27.6 respectively by the end of 2024. Crude incidence (per 100,000 persons) remained largely unchanged over the years [5.0 vs. 5.9 (EAPC: 0.3 (-0.8 to 1.5)], but the crude mortality (per 100,000 persons) increased from 1.1 to 2.2 [EAPC: 3.1 (2.1 to 4.2)]. The life-expentacy for female and male SLE patients were 77 and 73.8 years, respectively. While the age-standardized death rate for male showed a significant increase [EAPC 2.2 (0.4 to 4.1)], the rate for female has remained unchanged [EAPC 0.6 (-0.4 to 1.7)]. The female to male rate ratio for age-standardised prevalence, incidence and death rate were 8, 6 and 4, respectively, in 2024. Disparity in trends was also observed among different age groups.

Conclusion: The evolution of SLE management has led to increased disease prevalence. Such change in disease burden may be related to better immunosuppressive therapies and general medical care that has led to reduced early mortality.

The trends in crude and age-standardized rates of prevalence, incidence and death in SLE between 2005 and 2024

Estimated annual percentage change (EAPC) for crude and age-standardized rates of prevalence, incidence and death in SLE between 2005 and 2024

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/incidence-prevalence-and-mortality-of-systemic-lupus-erythematosus-a-20-year-territory-wide-analysis-of-electronic-health-records-in-hong-kong/