ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 725

Preliminary Population-Based Incidence and Prevalence Estimates of Primary Discoid Lupus and Cutaneous Lupus Erythematosus from the Manhattan Lupus Surveillance Program

Peter M. Izmirly1, Jill P. Buyon2, H. Michael Belmont3, Sara Sahl4, Isabella Wan5, Jane E. Salmon6, Anca Askanase7, Joan Bathon8, Laura Geraldino-Pardilla7, Yousaf Ali9, Ellen M. Ginzler10, Chaim Putterman11, Caroline Gordon12, Charles G. Helmick13 and Hilary Parton14, 1NYU Langone Health, New York, NY, 2Medicine, New York University School of Medicine, New York, NY, 3Medicine, NYU Langone Health, New York, NY, 4Pediatrics, Harbor-University of California at Los Angeles Medical Center, Torrance, CA, 5Medicine/Rheumatology, New York University School of Medicine, New York, NY, 6Medicine/Rheumatology, Hospital for Special Surgery, New York, NY, 7Rheumatology, Columbia University, College of Physicians & Surgeons, New York, NY, 8Division of Rheumatology, Columbia University, College of Physicians & Surgeons, New York, NY, 9Rheumatology, Mount Sinai Medical Center, New York, NY, 10Rheumatology, SUNY Downstate Medical Center, Brooklyn, NY, 11Rheumatology, Albert Einstein College of Medicine, Bronx, NY, 12Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom, 13Arthritis Program, Centers for Disease Control and Prevention, Atlanta, GA, 14Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene, Long Island City, NY

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Date: Sunday, October 21, 2018

Title: Systemic Lupus Erythematosus – Clinical Poster I: Clinical Manifestations and Comorbidity

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: The extant epidemiologic data of primary discoid lupus erythematosus (DLE) and primary cutaneous lupus erythematosus (CLE) remains limited with few published estimates for the general population and scant data regarding racial/ethnic populations in the U.S. DLE is associated with considerable morbidity given it tends to occur on the face, scalp, and ears and is associated with scarring and permanent alopecia. The Manhattan Lupus Surveillance Program (MLSP) is a population-based registry comprised of patients with Systemic Lupus Erythematosus (SLE) and related diseases treated in New York County (Manhattan) that was developed to determine the incidence and prevalence of SLE among Manhattan residents. Leveraging MLSP data we provide estimates of the prevalence and incidence of DLE and CLE during 2007 and 2007-09, respectively, in Manhattan across the major racial/ethnic populations (Black, Latino, Asian, White).

Methods: MLSP cases were identified from hospitals and associated lupus clinics, rheumatologists, and state population databases. Case screening was performed using a Manhattan address and ICD-9 codes, including 695.4 for DLE. Charts were abstracted and final diagnosis coded. DLE was defined as a diagnosis of primary DLE. CLE was defined as either a diagnosis of DLE, subacute cutaneous lupus erythematosus (SCLE), lupus profundus, chilblain lupus, or lupus tumidus. All diagnoses required notation by a rheumatologist, dermatologist, or pathologist. Patients who met ACR criteria for SLE were excluded.

Results: There were 74 prevalent and 26 incident primary DLE cases, resulting in preliminary age-adjusted overall prevalence and incidence rates of 4.4 and 0.5 per 100,000 person-years. Overall age-adjusted prevalence and incidence rates were 2 and 8 times higher among women compared with men, respectively. The age-adjusted prevalence of DLE was significantly higher among Blacks (15.1) and Latinos (4.8) compared with Whites (0.6) and Asians (0.6). The age-adjusted incidence of DLE was significantly higher among Blacks (1.8) compared with Whites (0.1) and Latinos (0.4). Diagnoses of SCLE, lupus profundus, chilblain lupus, and lupus tumidus were rare and thus the age-adjusted overall prevalence and incidence rates of CLE were similar to DLE (4.5 and 0.6 per 100,000 person-years, respectively). CLE, with 77 prevalent and 31 incident cases, had similar gender and racial ethnic differences.

Conclusion: Using data from a large population-based registry revealed substantial racial/ethnic and gender disparities in DLE and CLE among Manhattan residents. These data are consistent with the evidence of similar disparities among SLE patients with DLE and suggest Blacks are disproportionately affected whether they have the systemic or primary form. These data also provide epidemiologic estimates for DLE and CLE for the major racial/ethnic populations in the U.S.

Table 1: Age-adjusted rates of DLE and CLE among Manhattan residents, overall and by sex and race/ethnicity

Prevalent Cases, 2007

Rate per 100,000 person-years
(95% Confidence Interval)

Incident cases, 2007-2009

Rate per 100,000 person-years
(95% Confidence Interval)

Primary DLE

Total

4.4 (3.4-5.5)

0.5 (0.3 -0.7)

Male

2.5 (1.5 -3.9)

0.1 (0.0 -0.3)

Female

5.9 (4.4-7.8)

0.8 (0.5-1.3)

Race/ethnicity

Non-Latino White

0.6 (0.2-1.4)

0.1 (0.0-0.4)

Non-Latino Black

15.1 (10.4-21.1)

1.8 (0.9-3.2)

Latino

4.8 (2.9-7.5)

0.4 (0.1-0.9)

Non-Latino Asian

0.6 (0.0-3.5)

0.6 (0.1-1.7)

Primary CLE

Total

4.5 (3.6-5.7)

0.6 (0.4 -0.8)

Male

2.5 (1.5 -3.9)

0.1 (0.0 -0.3)

Female

6.2 (4.4-8.1)

1.0 (0.7-1.5)

Race/ethnicity

Non-Latino White

0.6 (0.2-1.4)

0.1 (0.0-0.4)

Non-Latino Black

15.1 (10.4-21.1)

1.8 (0.9-3.2)

Latino

5.7(3.5-8.6)

0.4 (0.1-0.9)

Non-Latino Asian

0.6 (0.0-3.5)

0.6 (0.1-1.7)

There were 77 CLE cases (31 incident) and 74 DLE cases (26 incident).

Rates are per 100,000 Manhattan residents. Denominator data is based on 2007-2009 intercensal population estimates from the NYC DOHMH Bureau of Epi Services (2000-2014 files).

Data are age adjusted to the US 2000 Standard Population.

Cases were assigned to one of five mutually exclusive race/ethnicity categories: non-Latino white, non-Latino black, non-Latino Asian, Latino, and non-Latino other. Non-Latino cases identified with more than one race were categorized as non-Latino other.

Disclosure: P. M. Izmirly, None; J. P. Buyon, None; H. M. Belmont, None; S. Sahl, None; I. Wan, None; J. E. Salmon, None; A. Askanase, None; J. Bathon, None; L. Geraldino-Pardilla, None; Y. Ali, None; E. M. Ginzler, None; C. Putterman, None; C. Gordon, None; C. G. Helmick, None; H. Parton, None.

To cite this abstract in AMA style:

Izmirly PM, Buyon JP, Belmont HM, Sahl S, Wan I, Salmon JE, Askanase A, Bathon J, Geraldino-Pardilla L, Ali Y, Ginzler EM, Putterman C, Gordon C, Helmick CG, Parton H. Preliminary Population-Based Incidence and Prevalence Estimates of Primary Discoid Lupus and Cutaneous Lupus Erythematosus from the Manhattan Lupus Surveillance Program [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/preliminary-population-based-incidence-and-prevalence-estimates-of-primary-discoid-lupus-and-cutaneous-lupus-erythematosus-from-the-manhattan-lupus-surveillance-program/. Accessed .

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