Background/Purpose: Ten-year survival of SLE has improved from <50% in the 1950s to ~95% in the 2000s. However, the relative and true disease burden for SLE is not understood. Disease burden can be measured using a variety of indicators such as mortality, morbidity or financial cost. A recent analysis of 62,843 SLE deaths from the Centers for Disease Control (CDC)’s mortality database showed that the age-standardized mortality rate for SLE remains high relative to general population mortality rate. However, mortality rates may not adequately measure SLE burden, because among those who died, a fifth of SLE patients died before reaching 40 years of age. Premature mortality is an important way to quantify disease burden. In constructing a measure of premature death, an arbitrary limit to life is chosen, and the calculation of the difference between an age at death and this arbitrary limit is defined as the life lost as a result of that death. Here, we measured the years of potential life lost (YPLL) for SLE relative to CDC’s top 15 leading causes of death and to 12 other autoimmune diseases.

Methods: This is a population-based study. Death counts were obtained from the CDC-WONDER database. Number of deaths between January 1, 2000 and December 31, 2015 were tabulated for 28 diseases, including SLE, top 15 CDC’s leading causes-of-death, and 12 other autoimmune diseases. To calculate YPLL, each decedent’s age at death from a specific disease was subtracted from a predetermined age of 75 years. The years of potential life lost were then added together to yield the total YPLL.

Results: SLE was recorded as the underlying or a contributing cause of death in 28,411 women from 2000 to 2015. The ranking of SLE deaths relative to the CDC’s official leading-causes-of-death list in females showed that SLE is within the top 15 leading causes-of-death in reproductive age women (15-44 years) and tenth among women ages 15-24 years. Hence, we calculated YPLL for SLE relative to the top 15 leading causes-of-death in women ages 15-44 and 15-24 years. YPLL for SLE was 304.2 thousand years in women ages 15-44 and 66.2 thousand years in women ages 15-24. SLE-YPLL ranked 14^th in women ages 15-44 and 8^th in women ages 15-24 above diabetes mellitus, HIV disease, septicemia, chronic lower respiratory disease, anemias, nephritis, and cerebrovascular disease. Among autoimmune diseases, SLE ranked #2 above insulin-dependent diabetes mellitus, myocarditis, multiple sclerosis, systemic sclerosis, rheumatoid arthritis, Addison’s disease, dermatomyositis, chronic active hepatitis, myasthenia gravis, primary biliary cirrhosis, and autoimmune hemolytic anemia in women ages 15-44 years. SLE ranked #1 autoimmune disease cause of YPLL in women ages 15-24 years.

Conclusion: SLE is among the leading causes of YPLL in young women, underscoring SLE as an important public health issue. SLE ranked #1 leading autoimmune disease cause of YPLL in women ages 15-24. These data warrant further studies on SLE disease burden, which can be used to develop and prioritize public health programs, assess performance of changes in SLE management, identify high-risk populations, and set research priorities and funding, which may eventually reduce SLE burden.

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/sle-among-the-leading-causes-of-years-of-potential-life-lost-in-young-women-population-based-study-2000-2015/