Background/Purpose: Most women with systemic lupus erythematosus (SLE) are diagnosed with the disease in their reproductive ages, but the burden of SLE among women in childbearing years remains incompletely understood. We aimed to investigate the burden of SLE among Korean women in childbearing years in terms of prevalence and incidence of disease, prevalence of comorbidity, medication dispensing, and pregnancy and delivery rate.

Methods: From National Health Insurance Service data during 2009-2016, women between 20-44 years of childbearing years were identified. Among these women, the prevalence and incidence of SLE were estimated. Women without chronic diseases (CD) or rheumatic diseases including SLE, rheumatoid arthritis, and ankylosing spondylitis were defined as controls. Prevalence of CD including cancer (Ca), diabetes mellitus (DM), hypertension (HTN), and hyperlipidemia (HLD) was compared in SLE women and controls. Medication uses including NSAIDs, corticosteroids (CSs), and conventional (c) disease-modifying anti-rheumatic drugs (DMARDs), pregnancy and delivery rates in women with SLE were compared with controls.

Results: Total 12,756 women with SLE and 208,941 controls were identified. The overall prevalence of SLE during 2009-2016 was 138.5 (95% CI 136.1-140.9) per 100,000 and overall incidence of SLE was 49.1 (95% CI 47.7-50.5) per 100,000 females in childbearing years during 2011-2016. SLE women had significantly increased prevalence of CD compared with the controls in the same age group (60.4% vs 25.6%, odds ratio (OR) 5.4, p< 0.0001). Each chronic disease including Ca (6.3% vs 4.2%, OR 4.2), DM (9.7% vs 6.0%, OR 1.9), HTN (35.2% vs 8.2%, OR 8.0), and HLD (38.3% vs 16.6%, OR 3.6) were all more prevalent in SLE women compared with the controls (p< 0.001). The use of any rheumatic diseases related medications including NSAIDs, CSs, cDMARDs were more frequent in women with SLE than controls (NSAIDs; 53.6% vs 21.8%, CSs; 81.0% vs 4.3%, cDMARDs; 89.0% vs 0.4%, all p< 0.001). Although pregnancy rate showed no difference between SLE women and controls (22.1% vs 19.3%, OR=0.97, p=0.38), delivery rate was significantly lower in SLE women compared with controls (18.7% vs 20.3%, OR 0.8, p< 0.001).

Conclusion: High prevalence and incidence, increased rates of comorbidities and medication use, and decreased odds to have successful delivery are causes of a significant burden in Korean women with SLE during their childbearing years.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/burden-of-systemic-lupus-erythematosus-among-korean-women-in-childbearing-years-based-on-the-national-health-insurance-service-data/