Survival in adults and children with systemic lupus erythematosus: a systematic review and Bayesian meta-analysis of studies from 1950 to 2016

ObjectiveTo determine trends in survival among adult and paediatric patients with systemic lupus erythematosus (SLE) from 1950 to the present.MethodsWe performed a systematic literature review to identify all published cohort studies on survival in patients with SLE. We used Bayesian methods to deri...

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Bibliographic Details
Published inAnnals of the rheumatic diseases Vol. 76; no. 12; pp. 2009 - 2016
Main Authors Tektonidou, Maria G, Lewandowski, Laura B, Hu, Jinxian, Dasgupta, Abhijit, Ward, Michael M
Format Journal Article
LanguageEnglish
Published United States BMJ Publishing Group Ltd and European League Against Rheumatism 01.12.2017
Elsevier Limited
Subjects
Adolescent
Adult
Adults
Arthritis
Bayes Theorem
Bayesian analysis
Calendars
Child
Children
Clinical and epidemiological research
Cohort Studies
Developed Countries - statistics & numerical data
Developing Countries - statistics & numerical data
Disease
Epidemiology
Estimates
Female
Health care access
High income
Human subjects
Humans
Income - statistics & numerical data
Literature reviews
Lupus
Lupus Erythematosus, Systemic - mortality
Male
Meta-analysis
Middle Aged
Mortality
Patients
pediatric
Quality
Risk Factors
Studies
Survival
Survival Rate - trends
Systematic review
Systemic lupus erythematosus
Time Factors
Trends
mortality
systemic lupus erythematosus
adult
survival
pediatric
Online AccessGet full text

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Abstract ObjectiveTo determine trends in survival among adult and paediatric patients with systemic lupus erythematosus (SLE) from 1950 to the present.MethodsWe performed a systematic literature review to identify all published cohort studies on survival in patients with SLE. We used Bayesian methods to derive pooled survival estimates separately for adult and paediatric patients, as well as for studies from high-income countries and low/middle-income countries. We pooled contemporaneous studies to obtain trends in survival over time. We also examined trends in major causes of death.ResultsWe identified 125 studies of adult patients and 51 studies of paediatric patients. Among adults, survival improved gradually from the 1950s to the mid-1990s in both high-income and low/middle-income countries, after which survival plateaued. In 2008–2016, the 5-year, 10-year and 15-year pooled survival estimates in adults from high-income countries were 0.95, 0.89 and 0.82, and in low/middle-income countries were 0.92, 0.85 and 0.79, respectively. Among children, in 2008–2016, the 5-year and 10-year pooled survival estimates from high-income countries were 0.99 and 0.97, while in low/middle-income countries were 0.85 and 0.79, respectively. The proportion of deaths due to SLE decreased over time in studies of adults and among children from high-income countries.ConclusionsAfter 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.
AbstractList To determine trends in survival among adult and paediatric patients with systemic lupus erythematosus (SLE) from 1950 to the present.OBJECTIVETo determine trends in survival among adult and paediatric patients with systemic lupus erythematosus (SLE) from 1950 to the present.We performed a systematic literature review to identify all published cohort studies on survival in patients with SLE. We used Bayesian methods to derive pooled survival estimates separately for adult and paediatric patients, as well as for studies from high-income countries and low/middle-income countries. We pooled contemporaneous studies to obtain trends in survival over time. We also examined trends in major causes of death.METHODSWe performed a systematic literature review to identify all published cohort studies on survival in patients with SLE. We used Bayesian methods to derive pooled survival estimates separately for adult and paediatric patients, as well as for studies from high-income countries and low/middle-income countries. We pooled contemporaneous studies to obtain trends in survival over time. We also examined trends in major causes of death.We identified 125 studies of adult patients and 51 studies of paediatric patients. Among adults, survival improved gradually from the 1950s to the mid-1990s in both high-income and low/middle-income countries, after which survival plateaued. In 2008-2016, the 5-year, 10-year and 15-year pooled survival estimates in adults from high-income countries were 0.95, 0.89 and 0.82, and in low/middle-income countries were 0.92, 0.85 and 0.79, respectively. Among children, in 2008-2016, the 5-year and 10-year pooled survival estimates from high-income countries were 0.99 and 0.97, while in low/middle-income countries were 0.85 and 0.79, respectively. The proportion of deaths due to SLE decreased over time in studies of adults and among children from high-income countries.RESULTSWe identified 125 studies of adult patients and 51 studies of paediatric patients. Among adults, survival improved gradually from the 1950s to the mid-1990s in both high-income and low/middle-income countries, after which survival plateaued. In 2008-2016, the 5-year, 10-year and 15-year pooled survival estimates in adults from high-income countries were 0.95, 0.89 and 0.82, and in low/middle-income countries were 0.92, 0.85 and 0.79, respectively. Among children, in 2008-2016, the 5-year and 10-year pooled survival estimates from high-income countries were 0.99 and 0.97, while in low/middle-income countries were 0.85 and 0.79, respectively. The proportion of deaths due to SLE decreased over time in studies of adults and among children from high-income countries.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.CONCLUSIONSAfter 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.
ObjectiveTo determine trends in survival among adult and paediatric patients with systemic lupus erythematosus (SLE) from 1950 to the present.MethodsWe performed a systematic literature review to identify all published cohort studies on survival in patients with SLE. We used Bayesian methods to derive pooled survival estimates separately for adult and paediatric patients, as well as for studies from high-income countries and low/middle-income countries. We pooled contemporaneous studies to obtain trends in survival over time. We also examined trends in major causes of death.ResultsWe identified 125 studies of adult patients and 51 studies of paediatric patients. Among adults, survival improved gradually from the 1950s to the mid-1990s in both high-income and low/middle-income countries, after which survival plateaued. In 2008–2016, the 5-year, 10-year and 15-year pooled survival estimates in adults from high-income countries were 0.95, 0.89 and 0.82, and in low/middle-income countries were 0.92, 0.85 and 0.79, respectively. Among children, in 2008–2016, the 5-year and 10-year pooled survival estimates from high-income countries were 0.99 and 0.97, while in low/middle-income countries were 0.85 and 0.79, respectively. The proportion of deaths due to SLE decreased over time in studies of adults and among children from high-income countries.ConclusionsAfter 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.
To determine trends in survival among adult and paediatric patients with systemic lupus erythematosus (SLE) from 1950 to the present. We performed a systematic literature review to identify all published cohort studies on survival in patients with SLE. We used Bayesian methods to derive pooled survival estimates separately for adult and paediatric patients, as well as for studies from high-income countries and low/middle-income countries. We pooled contemporaneous studies to obtain trends in survival over time. We also examined trends in major causes of death. We identified 125 studies of adult patients and 51 studies of paediatric patients. Among adults, survival improved gradually from the 1950s to the mid-1990s in both high-income and low/middle-income countries, after which survival plateaued. In 2008-2016, the 5-year, 10-year and 15-year pooled survival estimates in adults from high-income countries were 0.95, 0.89 and 0.82, and in low/middle-income countries were 0.92, 0.85 and 0.79, respectively. Among children, in 2008-2016, the 5-year and 10-year pooled survival estimates from high-income countries were 0.99 and 0.97, while in low/middle-income countries were 0.85 and 0.79, respectively. The proportion of deaths due to SLE decreased over time in studies of adults and among children from high-income countries. 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.
Objective To determine trends in survival among adult and paediatric patients with systemic lupus erythematosus (SLE) from 1950 to the present. Methods We performed a systematic literature review to identify all published cohort studies on survival in patients with SLE. We used Bayesian methods to derive pooled survival estimates separately for adult and paediatric patients, as well as for studies from high-income countries and low/middle-income countries. We pooled contemporaneous studies to obtain trends in survival over time. We also examined trends in major causes of death. Results We identified 125 studies of adult patients and 51 studies of paediatric patients. Among adults, survival improved gradually from the 1950s to the mid-1990s in both high-income and low/middle-income countries, after which survival plateaued. In 2008-2016, the 5-year, 10-year and 15-year pooled survival estimates in adults from high-income countries were 0.95, 0.89 and 0.82, and in low/middle-income countries were 0.92, 0.85 and 0.79, respectively. Among children, in 2008-2016, the 5-year and 10-year pooled survival estimates from high-income countries were 0.99 and 0.97, while in low/middle-income countries were 0.85 and 0.79, respectively. The proportion of deaths due to SLE decreased over time in studies of adults and among children from high-income countries. Conclusions 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.
Author Ward, Michael M
Lewandowski, Laura B
Dasgupta, Abhijit
Tektonidou, Maria G
Hu, Jinxian
Author_xml – sequence: 1
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  surname: Tektonidou
  fullname: Tektonidou, Maria G
  organization: Department of Propaedeutic Internal Medicine, Joint Academic Rheumatology Program, National and Kapodistrian University of Athens, Medical School, Athens, Greece
– sequence: 2
  givenname: Laura B
  surname: Lewandowski
  fullname: Lewandowski, Laura B
  organization: National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Intramural Research Program, Bethesda, Maryland, USA
– sequence: 3
  givenname: Jinxian
  surname: Hu
  fullname: Hu, Jinxian
  organization: National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Intramural Research Program, Bethesda, Maryland, USA
– sequence: 4
  givenname: Abhijit
  surname: Dasgupta
  fullname: Dasgupta, Abhijit
  organization: National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Intramural Research Program, Bethesda, Maryland, USA
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  givenname: Michael M
  surname: Ward
  fullname: Ward, Michael M
  organization: National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Intramural Research Program, Bethesda, Maryland, USA
BackLink https://www.ncbi.nlm.nih.gov/pubmed/28794077$$D View this record in MEDLINE/PubMed
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DOI 10.1136/annrheumdis-2017-211663
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Keywords mortality
systemic lupus erythematosus
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pediatric
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Snippet ObjectiveTo determine trends in survival among adult and paediatric patients with systemic lupus erythematosus (SLE) from 1950 to the present.MethodsWe...
To determine trends in survival among adult and paediatric patients with systemic lupus erythematosus (SLE) from 1950 to the present. We performed a systematic...
Objective To determine trends in survival among adult and paediatric patients with systemic lupus erythematosus (SLE) from 1950 to the present. Methods We...
To determine trends in survival among adult and paediatric patients with systemic lupus erythematosus (SLE) from 1950 to the present.OBJECTIVETo determine...
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StartPage 2009
SubjectTerms Adolescent
Adult
Adults
Arthritis
Bayes Theorem
Bayesian analysis
Calendars
Child
Children
Clinical and epidemiological research
Cohort Studies
Developed Countries - statistics & numerical data
Developing Countries - statistics & numerical data
Disease
Epidemiology
Estimates
Female
Health care access
High income
Human subjects
Humans
Income - statistics & numerical data
Literature reviews
Lupus
Lupus Erythematosus, Systemic - mortality
Male
Meta-analysis
Middle Aged
Mortality
Patients
pediatric
Quality
Risk Factors
Studies
Survival
Survival Rate - trends
Systematic review
Systemic lupus erythematosus
Time Factors
Trends
Title Survival in adults and children with systemic lupus erythematosus: a systematic review and Bayesian meta-analysis of studies from 1950 to 2016
URI https://ard.bmj.com/content/76/12/2009.full
http://ard.bmj.com/content/76/12/2009.full
https://www.ncbi.nlm.nih.gov/pubmed/28794077
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https://www.proquest.com/docview/1927829637
Volume 76
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