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Lupus is not listed in national mortality rankings but appears to be the 10th leading cause of death in females aged 15-24 years. Where to go from here?
Lupus is not listed in national mortality rankings, but the disease is one of the leading causes of death in young women in the United States, researchers have reported.
Systemic lupus erythematosus (SLE) is not among the 113 leading causes of death in Centers for Disease Control and Prevention (CDC) mortality statistics, which are used for planning healthcare policy and resources.
In fact, SLE appears to be the 10th leading cause of death in females 15-24 years of age, and the 5th leading cause of death for black and Hispanic women in that cohort, the researchers found in a population-based study.
“The inclusion of SLE in CDC’s selected list of causes of death for their annual ranking would highlight the importance of this disease as a major cause of death among young women,” researchers Ram R. Singh, MD, and Eric Y. Yen, MD, said in a report on the study appearing in the journal Arthritis & Rheumatology.
Recognizing SLE in mortality statistics could influence physician coding, government policy, and research funding, which may eventually help reduce the burden of the disease, according to Dr. Singh, of the Autoimmunity and Tolerance Laboratory in the Division of Rheumatology at the David Geffen School of Medicine, University of California at Los Angeles, and Dr. Yen, who is with the Department of Medicine at that institution.
The study was based on data in a CDC database that were extracted from death certificates issued between 2000 and 2015 for females in the United States. In those records, SLE was recorded as an underlying or contributing cause of death for 28,411 females.
#1 chronic inflammatory disease
There were 1,226 SLE-related deaths among females 15-24 years of age, making it the number one chronic inflammatory disease in that group. Overall, it was the 10th leading cause of death in that age cohort, ranking higher than diabetes mellitus, HIV, chronic lower respiratory disease, nephritis, pneumonitis, and liver diseases, the researchers reported.
SLE also ranked relatively high for other younger female age cohorts. It was the 14th leading cause of death for both the 25-34 and 35-44 age groups, and the 15th for the 10-14 age group.
Looking just at black and Hispanic females, SLE was the 5th leading cause of death for the 15-24 age group when several common external injury causes of death were excluded from the analysis, investigators said.
These findings underscore the importance of SLE as a public health problem in young women that could be better addressed through targeted programs in public health and research, Drs. Singh and Yen said in their report.
Increased awareness among primary care physicians and pediatricians could lead to better diagnosis and management of the condition, they noted.
The high mortality burden has not gone completely unrecognized, despite the omission from CDC mortality rankings.
In 2015, the National Institutes of Health increased SLE research funding to $90 million annually, researchers noted. By comparison, however, funding for diabetes exceeded $1 billion that year, and funding for HIV was at least $3 billion.
“In light of our data showing a higher burden of SLE mortality in younger women than previously perceived,” the authors concluded, “further increases in research funding for SLE is warranted.”
Yen EY, Singh RR. Lupus – an unrecognized leading cause of death in young women: population-based study using nationwide death certificates, 2000-2015. Arthritis Rheumatol. 2018 Apr 18. doi: 10.1002/art.40512. https://onlinelibrary.wiley.com/doi/pdf/10.1002/art.40512