Background/Purpose: Important disparities in SLE patients persist based on their sex and racial/ethnic status. The aim of this study is to examine the trends in SLE-related deaths stratified on age, sex, and race/ethnicity in the United States from 1999 to 2019.

Methods: We used CDC Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) to access National Vital Statistics System data from 1999 to 2019. SLE-related deaths (age >/= 15 years) were identified using the International Classification of Diseases, Tenth Revision, codes M32.x from multiple causes of death and were represented as age-adjusted mortality rates (AAMR) per 1,000,000 population. Joinpoint regression was used to examine changes in trend and annual percentage change (APC) in SLE related deaths overall and stratified by age groups (15-44 years [young], 45-74 years [midlife], and >/=75 years [old]), sex, racial/ethnic groups (non-Hispanic whites [NHWs], non-Hispanic blacks [NHBs], Hispanics, non-Hispanic Others [NH Others] (includes Asian or Pacific Islanders, and American Indian or Alaska Natives)).

Results: AAMR related to SLE decreased from 10.13 to 7.36 in 2013 (APC -2.3[95% CI, −2.7 to −1.9]) and then remained stable (7.83) after that till 2019 (APC 1.0[95% CI, 1.1 to [95% CI, −0.5 to −2.5]). AAMR was higher in women (13.41) than men (2.73) in all years. Among the racial/ethnic groups, AAMR was highest in NHBs (22.51), followed by Hispanics (9.07), NH-Others (6.93), and lastly, NHWs (5.76) in all years. AAMR was highest in old (23.24) followed by midlife (11.46) and young (4.28). APC in AAMR decreased in men (-2.8) till 2014 and women (-2.2) till 2013 and remained stable after that. APC in AAMR decreased in NHWs (-2.4) until 2014 and NHBs (-2.5) until 2013 and remained stable after that. APC in AAMR decreased throughout the study period in NH Others (-2.4) and Hispanics (-1.8). APC in AAMR decreased from 2006-2013 in young (-4.2) and remained stable after that. APC in AAMR decreased in midlife (-2.4) until 2012 and old (-2.6) until 2010 and remained stable after that.

Conclusion: After the initial decline, SLE-related mortality has remained stable since 2013. Stratification by racial/ethnic status reveals significant disparities, which calls for further research to understand the underlying factors to help develop preventative strategies.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/trends-in-disparity-by-age-sex-and-race-for-systemic-lupus-erythematosus-patients/