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Abstract Number: 2788

Preliminary Population- Based Incidence and Prevalence Estimates of SLE: The California Lupus Surveillance Project

Maria Dall'era1, Kurt Snipes2, Miriam Cisternas3, C. Gordon4 and Charles G. Helmick5, 1Medicine/Rheumatology, University of California, San Francisco, San Francisco, CA, 2California Department of Public Health, Sacramento, CA, 3MGC Data Services, San Diego, CA, 4Rheumatology (East Wing), Medical School, Birmingham, United Kingdom, 5National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Lupus and epidemiologic methods

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Session Information

Title: 2014 Rheumatology Research Foundation Edmond L. Dubois, MD Memorial Lectureship

Session Type: Abstract Submissions (ACR)

Background/Purpose: Previous estimates of prevalence and incidence of systemic lupus erythematosus (SLE) in the United States have varied widely.  The California Lupus Surveillance Project (CLSP) is part of a national effort funded by the Centers for Disease Control and Prevention (CDC) to determine more credible estimates of incidence and prevalence of SLE, with a special focus on Hispanics and Asians.

Methods: The CLSP is a population-based registry designed to determine the incidence and prevalence of SLE in San Francisco County, California.  Sources of cases included hospitals, rheumatologists, nephrologists, commercial laboratories, and state population databases.  Over 15,000 potential SLE patients were identified after the initial queries, and trained abstractors performed detailed medical chart reviews on the >5,500 patients who met the catchment criteria of residence in San Francisco County within the years of 2007-2009.  Cases were defined as patients with documentation of > 4/11 of the ACR Classification Criteria for SLE.  Using SAS 9.3, we calculated prevalence and incidence rates and associated 95% confidence intervals (CI). Denominators for all rates were obtained from the U.S. Census data (revised 2000-2009 intercensal population files) for San Francisco County.  

Results: Preliminary overall crude prevalence and incidence of SLE in San Francisco County were 90.4/100,000 and 5.1/100,000 respectively.  The highest prevalence of disease was observed in Black women (430.6/100,000), followed by Hispanic and Asian (163.8/100,000 and 158.9/100,000, respectively), and White (111.3/100,000) women (Table I).

Table I: Preliminary Prevalence and Incidence Rates (per 100,000) of SLE in San Francisco County, CA

 

Prevalence (2007)

Incidence (2007 – 2009)

Race/ethnicity, sex

# cases

Crude rate (95% CI)

# cases

Crude rate (95% CI)

Overall

704

90.4

(84.0 –

97.3)

121

5.1

(4.3 –

6.1)

Women

623

162.0

(149.8 –

175.2)

112

9.6

(8.0 –

11.5)

Men

81

20.6

(16.5 –

25.5)

9

0.7

(0.4 –

1.4)

Black

138

243.0

(205.7 –

287.0)

27

15.9

(10.9 –

23.1)

Women

121

430.6

(360.5 –

514.2)

25

29.9

(20.3 –

44.2)

Men

17

59.2

(37.0 –

94.9)

2

2.3

(0.6 –

8.4)

White

255

58.1

(51.4 –

65.7)

43

3.2

(2.4 –

4.3)

Women

230

111.3

(97.8 –

126.6)

38

6.0

(4.4 –

8.3)

Men

25

10.8

(7.3 –

15.9)

5

0.7

(0.3 –

1.7)

Asian

264

95.8

(84.9 –

108.1)

39

4.6

(3.4 –

6.3)

Women

233

158.9

(139.8 –

180.7)

37

8.3

(6.0 –

11.4)

Men

31

24.0

(16.9 –

34.1)

2

0.5

(0.1 –

1.9)

Hispanic

99

87.7

(72.1 –

106.8)

17

4.9

(3.1 –

7.8)

Women

87

163.8

(132.9 –

202.0)

16

9.8

(6.0 –

15.9)

Men

12

20.1

(11.5 –

35.1)

1

0.5

(0.1 –

3.1)

Conclusion: The CLSP uses more complete case finding methods to provide current estimates of prevalence and incidence in a racially and ethnically diverse population.  Racial and ethnic disparities in SLE were confirmed with the highest burden of disease in Black women, followed by Hispanic and Asians, and, finally, White women.


Disclosure:

M. Dall’era,
None;

K. Snipes,
None;

M. Cisternas,
None;

C. Gordon,
None;

C. G. Helmick,
None.

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