Prevalence and incidence of systemic lupus erythematosus in France: a 2010 nation-wide population-based study

To date, only a small number of studies have examined the epidemiology of systemic lupus erythematosus (SLE) on a nation-wide basis. We used French national administrative databases to analyze the nation-wide prevalence and incidence rates of SLE within the largest French health insurance scheme, which covers 86% of the population (almost 58,200,000 individuals). Patients with SLE were identified if they had full coverage for a chronic disease with a code (ICD-10th M32) in the health insurance information system, or if they had a SLE code in the hospital discharge database as a primary or secondary diagnosis in 2010. We defined incident cases as patients who had a new long-term disease diagnosis of SLE in 2010. Overall, 27,369 individuals were identified as having SLE, of whom 88% were female. The crude 2010 prevalence of identified SLE was 47.0/100,000, and the WHO age-standardized rate was 40.8/100,000. The crude 2010 annual incidence of SLE was 3.32 cases per 100,000 with peaks in females aged 30-39 years old (9.11/100,000) and in males aged 50-59 years old (1.78/100,000). Major differences in regional age-standardized prevalence rates were observed, with the highest rates in the Caribbean oversea areas (up to 126.7/100,000), and the lowest rates in north-western metropolitan territories (down to 29.6/100,000). This is the largest nation-wide population-based study of SLE patients to date, based on more than 58 million beneficiaries of the French health insurance system. These data and subsequent analyses provide guidance to both clinicians and policymakers for improving care of SLE.