Long-term outcomes in systemic lupus erythematosus: trends over time and major contributors

Rheumatology (Oxford). 2020 Dec 5;59(Suppl5):v29-v38. doi: 10.1093/rheumatology/keaa382.


SLE is a chronic autoimmune rheumatic disorder of high heterogeneity in clinical presentation, treatment response and prognosis. Long-term outcomes in SLE have been dramatically improved over the past decades, however, increased morbidity and mortality, especially among young individuals, still exists. Unmet needs include residual disease activity and frequent flares, glucocorticoid treatment dependency and toxicity, comorbidity burden, reduced health-related quality of life, health disparities and damage. The main determinants of long-term outcomes in SLE are age, sex, race/ethnicity, genetic profile, environmental factors including smoking, disease activity, major organ involvement such as lupus nephritis and CNS involvement, comorbidities including cardiovascular disease and serious infections, coexistence with APS, treatment adherence, socio-economic factors and access to care. In this review we discuss trends in long-term outcomes in SLE over the years and major contributors such as genetic, disease-related, treatment, comorbidity, socio-economic and other factors.

Keywords: SLE; comorbidities; damage; glucocorticoids; long-term outcomes; lupus nephritis; mortality; smoking; socio-economic factors; treatment adherence.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Comorbidity
  • Humans
  • Lupus Erythematosus, Systemic / pathology
  • Lupus Erythematosus, Systemic / therapy*
  • Remission Induction
  • Treatment Outcome