Changes in the incidence and prevalence of systemic lupus erythematosus between 1990 and 2020: an observational study using the Clinical Practice Research Datalink (CPRD)

Jessica Ellis; Neil McHugh; John D. Pauling; Ian N. Bruce; Rachel Charlton; Anita McGrogan; Sarah Skeoch

doi:10.1136/lupus-2024-001213

Changes in the incidence and prevalence of systemic lupus erythematosus between 1990 and 2020: an observational study using the Clinical Practice Research Datalink (CPRD)

Jessica Ellis, Neil McHugh, John D. Pauling, Ian N. Bruce, Rachel Charlton, Anita McGrogan, Sarah Skeoch

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: To obtain updated estimates on the incidence and prevalence of systemic lupus erythematosus (SLE) in the UK, over the period 1990–2020, using the Clinical Practice Research Datalink (CPRD).

Methods: This was a retrospective cohort study using the CPRD covering the period 1990–2020. A case ascertainment algorithm was developed in line with best practice recommendations for observational research. Incidence was calculated per 100 000 person-years and point prevalence (at the mid-year point) calculated per 100 000. Results were stratified by sex.

Results: 9443 SLE cases were identified. 5278 incident cases were identified (4538 women, 740 men). The overall incidence rate was 5.47 (95% CI 5.33 to 5.62) cases per 100 000 person-years. Incidence rates decreased slightly across the study period, which was more pronounced for women than men. Point prevalence increased over time, from 21.4 (95% CI 17.68 to 25.67) per 100 000 in 1990 to 107.14 (95% CI 103.26 to 111.12) per 100 000 in 2020.

Conclusions: The observed fivefold increase in prevalence of SLE over the last 30 years, in the context of a modest decline in incidence rate, may suggest improved outcomes in SLE and has important implications for healthcare service delivery and planning in the UK.

Original language	English
Article number	e001213
Journal	Lupus Science and Medicine
Volume	11
Issue number	2
Early online date	27 Jul 2024
DOIs	https://doi.org/10.1136/lupus-2024-001213
Publication status	Published - 27 Jul 2024

Data Availability Statement

Data are available upon reasonable request. The data underlying this article were provided by Clinical Practice Research Datalink under license. Available data will be shared on request to the corresponding author with permission of the Clinical Practice Research Datalink.

Funding

This study is based on part on data from the Clinical Practice Research Datalink obtained under licence from the UK Medicines and Healthcare Products Regulatory Agency. The data are provided by patients and collected by the NHS as part of their care and support. The interpretation and conclusions contained in this study are those of the author/s alone. We thank Julia Snowball (University of Bath) for her assistance with data extraction and management. INB is a National Institute for Health Research (NIHR) Senior Investigator Emeritus and is funded by the NIHR Manchester Biomedical Research Centre (NIHR203308). JDP has undertaken consultancy work and/or received speaker honoraria from Janssen, Astra Zeneca, Boehringer Ingelheim, IsoMab, Sojournix Pharma and Permeatus Inc. INB has received grant support from GSK, Janssen and Astra Zeneca; consulting fees from AstraZeneca, Eli Lilly, GSK, Takeda, UCB and Dragonfly Therapeutics; and was a speaker for AstraZeneca, Janssen, GSK and UCB. The remaining authors declare no conflicts of interest.

Funders	Funder number
UK Medicines and Healthcare Products Regulatory Agency
National Institute for Health and Care Research
Eli Lilly and Company
Takeda Pharmaceutical International
UCB Biopharma
GlaxoSmithKline
Manchester Biomedical Research Centre	NIHR203308

Keywords

Epidemiology
Incidence
Lupus Erythematosus
Prevalence
Systemic

ASJC Scopus subject areas

Rheumatology
Immunology

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10.1136/lupus-2024-001213Licence: CC BY-NC

Cite this

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title = "Changes in the incidence and prevalence of systemic lupus erythematosus between 1990 and 2020: an observational study using the Clinical Practice Research Datalink (CPRD)",

abstract = "Objective: To obtain updated estimates on the incidence and prevalence of systemic lupus erythematosus (SLE) in the UK, over the period 1990–2020, using the Clinical Practice Research Datalink (CPRD). Methods: This was a retrospective cohort study using the CPRD covering the period 1990–2020. A case ascertainment algorithm was developed in line with best practice recommendations for observational research. Incidence was calculated per 100 000 person-years and point prevalence (at the mid-year point) calculated per 100 000. Results were stratified by sex. Results: 9443 SLE cases were identified. 5278 incident cases were identified (4538 women, 740 men). The overall incidence rate was 5.47 (95% CI 5.33 to 5.62) cases per 100 000 person-years. Incidence rates decreased slightly across the study period, which was more pronounced for women than men. Point prevalence increased over time, from 21.4 (95% CI 17.68 to 25.67) per 100 000 in 1990 to 107.14 (95% CI 103.26 to 111.12) per 100 000 in 2020. Conclusions: The observed fivefold increase in prevalence of SLE over the last 30 years, in the context of a modest decline in incidence rate, may suggest improved outcomes in SLE and has important implications for healthcare service delivery and planning in the UK.",

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AB - Objective: To obtain updated estimates on the incidence and prevalence of systemic lupus erythematosus (SLE) in the UK, over the period 1990–2020, using the Clinical Practice Research Datalink (CPRD). Methods: This was a retrospective cohort study using the CPRD covering the period 1990–2020. A case ascertainment algorithm was developed in line with best practice recommendations for observational research. Incidence was calculated per 100 000 person-years and point prevalence (at the mid-year point) calculated per 100 000. Results were stratified by sex. Results: 9443 SLE cases were identified. 5278 incident cases were identified (4538 women, 740 men). The overall incidence rate was 5.47 (95% CI 5.33 to 5.62) cases per 100 000 person-years. Incidence rates decreased slightly across the study period, which was more pronounced for women than men. Point prevalence increased over time, from 21.4 (95% CI 17.68 to 25.67) per 100 000 in 1990 to 107.14 (95% CI 103.26 to 111.12) per 100 000 in 2020. Conclusions: The observed fivefold increase in prevalence of SLE over the last 30 years, in the context of a modest decline in incidence rate, may suggest improved outcomes in SLE and has important implications for healthcare service delivery and planning in the UK.

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Changes in the incidence and prevalence of systemic lupus erythematosus between 1990 and 2020: an observational study using the Clinical Practice Research Datalink (CPRD)

Abstract

Data Availability Statement

Funding

Keywords

ASJC Scopus subject areas

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