Brazilian Study Suggests Low Income Leads to Faster Lupus Progression and a Worse Outcome

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by Alice Melão |

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Lupus and poverty

A Brazilian study makes a connection between income, lupus progression and lupus outcomes.

The less income a person has, the more likely that their disease will progress faster and that they will have a poor outcome, according to the research, which confirmed a California study’s results.

Other factors that the team correlated with faster progression and poorer outcome included the length of time a person has the disease and older age.

The key lesson from the study is that lupus patients need adequate socioeconomic support to help them manage their disease better and have a better outcome, the researchers said.

They published their study, titled “The Influence of Income and Formal Education on Damage in Brazilian Patients With Systemic Lupus Erythematosus,” in the Journal of Clinical Rheumatology.

Lupus is an autoimmune disorder that can damage many organs and severely diminish patients’ quality of life. Factors like race and the length of time someone has lupus can influence its progression and patients’ prognosis, other studies have shown.

Recent research also showed a connection between lower socioeconomic status and the level of the disease. A Brazil team wondered if that connection would hold in another study.

They looked at the medical records of 523 people who had had lupus at least a year, and obtained information about their socioeconomic status with a questionnaire. The medical records covered information like symptoms, the damage lupus had caused, other diseases patients had, laboratory test results, and medications patients were taking.

Patients’ median monthly income was $276, and 64 percent were unemployed, the team discovered. The patients also had poor scores on the American College of Rheumatology/Systemic Lupus International Collaborating Clinics Damage Index.

“Poorer patients had greater difficulties to regularly attend their medical appointments, as well as maintain the regular use of medication that is not always available in the public health system,” the researchers wrote. “Sometimes these patients do not have money for transportation to attend medical consultations, perform laboratory tests, or even to get medication provided by the health system.”

Duration of disease, age, race, income, and employment status were all independently associated with increased lupus-related damage, the team reported. They found no association between patients’  educational levels and their disease.

The results confirmed the findings of a University of California at San Francisco study showing a connection between poverty and worse lupus-related health problems over time.

“Unmodified characteristics such as longer disease duration, older age, and self-report as nonwhite race were associated with damage,” the researchers said. “However, low income and the incapacity to work because of lupus were also associated with organ damage.”