The survival rates of adults and children with systemic lupus erythematosus (SLE) has not increased in the past 20 years, according to the results of a systematic review and meta-analysis.
The study, “Survival in adults and children with systemic lupus erythematosus: a systematic review and Bayesian meta-analysis of studies from 1950 to 2016,” was published in the journal Annals of the Rheumatic Diseases.
From the 1950s to the 1990s, the five-year survival of adult lupus patients improved from 50% to 60% to more than 95%. Similarly, children with SLE also saw marked improvements in their survival during that time, with the five-year survival increasing from 60% to 70% in the 1950s to more than 90% in the 1980s.
Recent data, however, suggests that the improvements in survival slowed down from the 1980s onward.
To confirm these findings, researchers at the National and Kapodistrian University of Athens and the National Institute of Arthritis and Musculoskeletal and Skin Diseases conducted a review of published studies measuring survival in adult and pediatric patients with SLE.
The team included all studies published between 1950 and 2016, without any language restriction, and from both high-income and low- and middle-income countries. In total, 125 studies with adult SLE patients, and 51 studies with SLE children, were identified.
For the four decades from the 1950s to the mid-1990s, patients from both high-income and low/middle-income countries had a gradual improvement in their survival.
But after that period, the survival rates reached a plateau in both high- and low/middle-income countries. From 2008 to 2016 the five-year, 10-year, and 15-year survival rates for adult SLE patients in high-income countries were 0.95, 0.89 and 0.82, respectively. In low/middle-income countries, they were 0.92, 0.85 and 0.79, respectively.
During that 2008-2016 period, the five-year and 10-year survival rates of children with lupus from high-income countries was 0.99 and 0.97, respectively. In low-income countries, the survival rates were 0.85 and 0.79, respectively.
“Differences in survival between high-income countries and low/middle-income countries were more striking in pediatric SLE studies, with a gap in 10-year survival of 0.97 and 0.79, respectively,” the researchers wrote.
Deaths due to SLE decreased over time in both adult and children in high-income countries. But in poorer countries, SLE remained one of the leading causes of death in pediatric patients.
Overall, “after a period of major improvement, survival in SLE has plateaued since the mid-1990s. In high-income countries, 5-year survival exceeds 0.95 in both adults and children. In low/middle-income countries, 5-year and 10-year survival was lower among children than adults,” the study concluded.