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Abstract
Background Updated information regarding the epidemiology and survival of SLE in the last decade is scanty. We aimed at estimating the incidence, prevalence, and survival of SLE in northeastern Italy over the period 2012–2020.
Methods A retrospective population-based study was conducted in Veneto Region (4.9 million people) using the Population Registry, an administrative health database where all residents are recorded, which was linked with healthcare copayment exemption database, hospital discharge records, and mortality records. Between 2012 and 2020, SLE cases were defined by a healthcare copayment exemption for SLE (national registry code 028) or any hospital diagnosis of SLE (ICD-9-CM 710.0), whichever came first. Standardized incidence and prevalence were reported by age and gender; trends during the follow-up were analyzed through Poisson regression models. SLE mortality rates (MRs) and standardized mortality ratios (SMRs) were calculated. MRs per 1,000 were stratified by year, sex, and age. SMRs were derived by comparing MRs of the general regional population.
Results We identified 4,283 SLE patients (85% female), with 1,092 incident cases. Across the study period, SLE standardized point prevalence increased from 66.7 (95% CI 64.3–69.0) to 72.9 per 100,000 residents (95%CI 70.5–75.3, p<0.0001, figure 1A). SLE incidence was 2.8 per 100,000 (95%CI 2.6–2.9), with an 8% annual decline (p<0.0001, figure 1B). The highest incidence was observed in women aged 30–39: 8.40 (7.31–9.65). Among prevalent cases, 603 deaths occurred, corresponding to an MR of 18.6 (95%CI 17.0–20.2) per 1,000 person/year. Ninety out of 1,092 incident cases died, corresponding to an MR of 16.7 (13.3–20.3) per 1,000 person/year. Five- and 8-year survival was 91% and 89%, respectively. Overall, SMR was 2.65 (2.13–3.26).
Conclusions Over the last decade, SLE prevalence has increased, and incidence has declined. Survival since SLE diagnosis is good, however mortality is still higher in SLE patients compared with the general population.
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