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What is Systemic Lupus Erythematosus (SLE)?

SLE is a chronic, multisystem autoimmune disorder that can affect nearly every major organ system, causing inflammation, tissue injury, organ damage, and, ultimately, organ dysfunction.1 Severity of the disease can vary from mild to potentially fatal. The course of the disease over the patient's life is also highly variable.1

Pathogenesis of SLE

SLE is characterized by the pathologic production of antibodies directed against self-antigens.2 Multiple factors result in systemic immune dysregulation leading to SLE:

  • Environmental triggers, multiple genetic polymorphisms, ultraviolet light, and sex hormone interactions are all thought to have major roles.3,4

SLE Epidemiology

 

"Hispanic, African American and Asian patients with SLE tend to experience greater disease activity and faster accrual of organ damage... 5"

  • In the United States, ~240,000 to 320,000 adults have SLE (calculated estimate).6-8*
  • Nine out of 10 cases occur in women. Most of these women are between the ages of 15 and 45.9
  • Younger patients with SLE have a greater risk of poor clinical outcomes.10
  • SLE is 2 to 4 times more frequent and more severe among non-white populations.5  
  • ~20% to 25% of SLE patients are hospitalized annually.12,13 
  • 1 in 6 are readmitted in 30 days.14

 

Learn more about challenges in diagnosing SLE.

* The estimate for the US is derived from using the overall low and high end prevalence range estimates from three registries6,7,11 based on a US population of approximately 330 million in December 2019.8

References:

  1. American College of Rheumatology Ad Hoc Committee on Systemic Lupus Erythematosus Guidelines. Guidelines for referral and management of systemic lupus erythematosus in adults. Arthritis Rheum. 1999;42(9):1785-1796.   http://www.ncbi.nlm.nih.gov/pubmed/10513791. Accessed February 6, 2020. 
  2. Moulton V, Suarez-Fueyo A, Meidan E,et al. Pathogenesis of Human Systemic Lupus Erythematosus: A Cellular Perspective. Trends Mol Med. 2017 July: 23(7):615-635. doi:10.1016/j.molmed.2017.05.006
  3. Stockl A. Complex syndromes, ambivalent diagnosis, and existential uncertainty: The case of systemic lupus erythematosus (SLE). Soc Sci Med. 2007;65(7):1549-1559. https://doi.org/10.1016/j.socscimed.2007.05.016. Accessed February 6, 2020.
  4. Bertsias G, Cervera R, Boumpas DT. Systemic lupus erythematosus: pathogenesis and clinical features. In: EULAR Textbook on Rheumatic Diseases. 476-505. http://www.eular.org/myUploadData/files/sample%20chapter20_mod%2017.pdf. Accessed February 6, 2020. 
  5. Pons-Estel GJ, Alarcón GS, Scofield L, et al. Understanding the epidemiology and progression of systemic lupus erythematosus. Semin Arthritis Rheum. 2010;39(4):257. http://dx.doi.org/10.1016/j.semarthrit.2008.10.007. Accessed February 6, 2020. 
  6. Somers EC, Marder W, Cagnoli P, et al. Population-based incidence and prevalence of systemic lupus erythematosus: the Michigan Lupus Epidemiology and Surveillance program. Arthritis Rheum. 2014;66(2):369-378. http://dx.doi.org/10.1002/art.38238. Accessed February 6, 2020. 
  7. Dall’Era M, Cisternas MG, Snipes K, et al. The Incidence and Prevalence of Systemic Lupus Erythematosus in San Francisco County, California: The California Lupus Surveillance Project. Arthritis Rheumatol. 2017;69(10):1996-2005. http://dx.doi.org/10.1002/art.40191. Accessed March 11, 2020.
  8. US Census Bureau. https://www.census.gov/popclock/. Accessed December 25, 2019.
  9. Howard CH, Mayhew SL. The pharmacist's role in the treatment of systemic lupus erythematosus. US Pharm. 2006;5:39-48. https://www.uspharmacist.com/article/the-pharmacists-role-in-the-treatment-of-systemic-lupus-erythematosus. Accessed February 6, 2020. 
  10. Tucker LB, Uribe AG, Fernandez M, et al. Adolescent onset of lupus results in more aggressive disease and worse outcomes: results of a nested matched case-control study within LUMINA, a multiethnic US cohort (LUMINA LVII). Lupus. 2008;17(4):314-322. http://dx.doi.org/10.1177/0961203307087875. Accessed February 6, 2020. 
  11. Lim SS, Bayakly AR, Helmick CG, et al. The incidence and prevalence of systemic lupus erythematosus, 2002-2004: The Georgia Lupus Registry. Arthritis Rheumatol. 2014:66:357-368.
  12. Bernatsky S, Boivin JF, Joseph L, et al. Mortality in systemic lupus erythematosus. Arthritis Rheum. 2006;54(8):2550-2557. http://dx.doi.org/10.1002/art.21955. Accessed February 6, 2020. 
  13. Panopalis P, Yazdany J, Gillis JZ, et al. Health care costs and costs associated with changes in work productivity among persons with systemic lupus erythematosus. Arthritis Rheum. 2008;59(12):1788-95. http://dx.doi.org/10.1002/art.24063. Accessed February 6, 2020. 
  14. Yazdany J,Marafino BJ, Dean ML, et al. Thirty-day hospital readmissions in systemic lupus erythematosus. Arthirits Rheum. 2014;66(10):2828-2836. http://dx.doi.org/10.1002/art.38768. Accessed February 6, 2020.