ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2943

Preliminary Population-Based Incidence and Prevalence Estimates of Systemic Lupus Erythematous from the Manhattan Lupus Surveillance Program

Peter M. Izmirly1, Isabella Wan2, Sara Sahl1, Jill P. Buyon3, H. Michael Belmont4, Jane E. Salmon5,6, Joan M. Bathon7, Anca Askanase8, Laura Geraldino-Pardilla9, Yousaf Ali10, Ellen M. Ginzler11, Chaim Putterman12, Caroline Gordon13, Charles G. Helmick14 and Hilary Parton15, 1Medicine, Division of Rheumatology, New York University School of Medicine, New York, NY, 2Rheumatology, New York University School of Medicine, New York, NY, 3Department of Medicine, Division of Rheumatology, New York University School of Medicine, New York, NY, 4New York University School of Medicine, New York, NY, 5Dept of Medicine, Hospital for Special Surgery, Weill Cornell Medical College, New York, NY, 6Rheumatology, Hospital for Special Surgery, New York, NY, 7Rheumatology, Columbia University College of Physicians & Surgeons, New York, NY, 8Columbia University College of Physicians & Surgeons, New York, NY, 9Division of Rheumatology, Columbia University College of Physicians & Surgeons, New York, NY, 10Icahn School of Medicine at Mount Sinai, New York, NY, 11Medicine/Box 42, SUNY-Downstate, Brooklyn, NY, 12Division of Rheumatology, Albert Einstein College of Medicine, Bronx, NY, 13School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom, 14Arthritis Program, Centers for Disease Control and Prevention, Atlanta, GA, 15Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene, Long Island City, NY

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: ,

Session Information

Date: Tuesday, November 10, 2015

Title: Systemic Lupus Erythematosus - Clinical Aspects and Treatment Poster Session III

Session Type: ACR Poster Session C

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

Background/Purpose: Given widely varying estimates of the incidence and prevalence of Systemic Lupus Erythematous (SLE) in the US and the absence of data for certain demographic groups attention has turned to obtaining a better epidemiologic understanding of SLE across key ethnic/racial groups. Recently the Centers for Disease Control and Prevention supported four local health departments as well as the Indian Health Service to more rigorously capture cases SLE through the implementation of a population-based registry, the Manhattan Lupus Surveillance Program (MSLP), comprised of SLE patients treated in New York County. The primary goal of the MLSP is to capture information that can be used to determine the prevalence of SLE in 2007 and incidence of SLE during 2007-09 among Manhattan residents. Of specific interest are SLE rates among Hispanics and Asians where epidemiologic data are very limited.

Methods: Potential MLSP cases were identified from Manhattan-based hospitals and rheumatologists, and state population databases. More than 75,000 potential SLE patients were initially identified by screening for key ICD-9 codes. After additional screening based on Manhattan residence and deduplication, trained medical abstractors performed detailed medical chart review  on the remaining ~6,400 patients for information on SLE and related conditions.  Preliminary MLSP estimates of SLE were calculated based on two current criteria developed by the ACR and the Systemic Lupus International Collaborating Clinics (SLICC). Cases were defined as fulfilling 1) > 4/11 of the ACR classification criteria or 2) the SLICC criteria.  Prevalence rates, based on SLE diagnosis by 2007, and incidence rates, based on new SLE diagnosis in 2007-09, and associated 95% confidence intervals (CI) were calculated using denominators obtained from the US Census data (revised 2000-2009 intercensal population files) for Manhattan.  

Results: Based on the ACR criteria, the preliminary age-adjusted overall prevalence and incidence rates of SLE in New York County were 63.2 and 4.3 per 100,000 population, respectively. The overall prevalence and incidence rates were 10 times higher in females than males (Table 1). The highest prevalence of SLE was observed among black women (195.3), followed by Hispanic women (132.5), Asian women (89.5) and white women (61.9). Using the SLICC criteria generated age-adjusted overall prevalence and incidence rates of 70.4 and 5.5 per 100,000 population, respectively. Incidence and prevalence rates for all demographics were higher using the SLICC criteria for SLE than the ACR criteria (Table 1).

Conclusion: Using a more complete case finding methodology, the MLSP revealed substantial gender, ethnic and racial disparities in SLE among Manhattan residents.  Black women had the highest prevalence rate of SLE followed by Hispanic, Asian and white women. The SLICC criteria provided higher SLE prevalence and incidence rates than the ACR criteria.

Preliminary Prevalence and Incidence Rates (per 100,000) of SLE in New York (Manhattan), NY

 

                        Prevalence (2007)

                    Incidence (2007-2009)

 

             Age-adjusted Estimate (95% CI)

           Age-adjusted Estimate (95% CI)

Race/Ethnicity, Sex

ACR Criteria

SLICC Criteria

ACR Criteria

SLICC Criteria

Overall

63.2 (59.5 – 66.9)

70.4 (66.5 – 74.3)

4.3 (3.7 – 4.9)

5.5 (4.9 – 6.1)

       Female

106.5 (99.9 – 113.1)

119.7 (112.7 – 126.7)

7.3 (6.3 – 8.3)

9.2 (8.1 – 10.3)

       Male

13.2 (10.7 – 15.7)

13.5 (10.9 – 16.1)

0.9 (0.5 – 1.3)

1.3 (0.8 – 1.8)

Black

120.4 (106.3 – 134.5)

132.8 (118.0 – 147.6)

9.2 (6.9-11.5)

11.1 (8.6 – 13.6)

       Female

195.3 (171.0 – 219.6)

216.2 (190.7 – 241.7)

15.6 (11.5 – 19.7)

17.9 (13.5 – 22.3)

       Male

31.5 (20.6 – 42.4)

32.3 (21.3 – 43.3)

2 (0.4 – 3.6)

3.2 (1.2 – 5.2)

White

34.4 (30.6 – 38.2)

38.4 (34.4 -42.4)

3 (2.4 – 3.6)

3.7 (3.0 – 4.4)

       Female

61.9 (54.8 – 69.0)

68.7 (61.2 – 76.2)

5.5 (4.3 – 6.7)

6.6 (5.3 – 7.9)

       Male

4.3 (2.3 – 6.3)

5.2 (3.0 – 7.4)

0.4 (0.1 – 0.7)

0.7 (0.2 – 1.2)

Hispanic

82.0 (73.2 – 90.8)

85.9 (76.9 – 94.9)

3.3 (2.3 – 4.3)

4.0 (2.9 – 5.1)

       Female

132.5 (117.4 – 147.6)

139.6 (124.1 – 155.1)

5.0 (3.3 – 6.7)

6.3 (4.4 – 8.2)

       Male

18.9 (12.4 – 25.4)

19.5 (13.0 – 26.0)

1.2 (0.3 – 2.1)

1.2 (0.3 – 2.2)

Asian

55.4  (45.0 – 65.8)

67.5 (56.0 – 79.0)

3.8 (2.2 – 5.4)

6.1 (4.1 – 8.1)

       Female

89.5 (71.6 – 107.4)

112.5 (92.5 – 132.5)

6.5 (3.7 – 9.3)

9.8 (6.4 – 13.2)

       Male

12.3 (5.3 – 19.0)

11.4 (4.9 – 17.9)

0.5 (-0.5 – 1.5)

1.5 (-0.2 – 3.2)

Data reflects cases abstracted as of 5/31/2015. These estimates do not include all Manhattan cases for the study period. Data abstraction is expected to be completed in mid-2015.                             

Denominator data for NYC rates is based on NYC DOHMH intercensal population estimates.

NYC data are age adjusted to the US 2000 Standard Population.

Disclosure: P. M. Izmirly, None; I. Wan, None; S. Sahl, None; J. P. Buyon, None; H. M. Belmont, None; J. E. Salmon, None; J. M. Bathon, None; A. Askanase, 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, Wan I, Sahl S, Buyon JP, Belmont HM, Salmon JE, Bathon JM, Askanase A, Geraldino-Pardilla L, Ali Y, Ginzler EM, Putterman C, Gordon C, Helmick CG, Parton H. Preliminary Population-Based Incidence and Prevalence Estimates of Systemic Lupus Erythematous from the Manhattan Lupus Surveillance Program [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/preliminary-population-based-incidence-and-prevalence-estimates-of-systemic-lupus-erythematous-from-the-manhattan-lupus-surveillance-program/. Accessed .

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