What are the mortality rates for systemic lupus erythematosus (SLE)?

Updated: Aug 04, 2021
  • Author: Christie M Bartels, MD, MS; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Although historically, SLE was associated with a reduced life expectancy, mortality in patients with SLE has decreased over the past few decades. [65] Prior to 1955, the 5-year survival rate in SLE was less than 50%; currently, the average 10-year survival rate exceeds 90%, [66, 62] and the 15-year survival rate is approximately 80%. [67] Previously, mortality was due to the disease itself; currently, mortality is often a result of medication side effects (eg, fatal infections in individuals receiving potent immunosuppressive medications) or cardiovascular events.

A review of over 15,000 incident SLE patients by Li et al concluded that patients with high initial severity of SLE had elevated risk of all-cause mortality and CVD events compared with those who presented with milder disease. After multivariable adjustment, the CVD subdistribution hazard ratio (HRSD) for initially severe SLE versus mild SLE was 1.64 (95% confidence index [CI] 1.32, 2.04). The HR for mortality was 3.11 (95% CI 2.49, 3.89). [68]

Ten-year survival rates in Asia and Africa are significantly lower than those in the United States, ranging from 60-70%, [69, 70] but this may reflect detection bias of severe cases only.


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