Epidemiology of Systemic Lupus Erythematosus and Other Connective Tissue Diseases in Rochester, Minnesota, 1950 Through 1979

Michet, Clement J.; Mckenna, Charles H.; Elveback, Lila R.; Kaslow, Richard A.; Kurland, Leonard T.

doi:10.1016/s0025-6196(12)60294-8

Cited by 236 publications

(123 citation statements)

References 15 publications

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“…The Rochester population has a strong Nordic background and the overall incidence rate for the study was 3.0/100,000 9 , similar to our data, so the increase observed in Rochester may be a catchup effect. The trend towards increasing AIR in women for the 30-49 age group (8.3) is in line with other studies 5,6,25 , however, aside from the high AIR (14.1) seen in women 65-74 years old in southern Sweden 10 . SLE prevalence in Northern Norway was highest in postmenopausal women (1.3 per 1,000), making SLE a disease currently seen in 1 per 770 women in this age group.…”

Section: Discussionsupporting

confidence: 91%

The Influence of the 1997 Updated Classification Criteria for Systemic Lupus Erythematosus: Epidemiology, Disease Presentation, and Patient Management

Eilertsen¹,

Becker-Merok²,

Nossent³

2009

J Rheumatol

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ABSTRACT. Objective. The 1997 update of the American College of Rheumatology classification criteria (ACR97) for systemic lupus erythematosus (SLE) has not been validated. We determined to what extent their introduction influenced the epidemiology and clinical characteristics of the disease in northern Norway. Methods. Annual incidence and point-prevalence rates, clinical manifestations, and outcome were determined in an inception cohort of patients with SLE in northern Norway, included between 1996 and 2006, using ACR97 criteria (97acr). These findings were compared with a cohort from the same area enrolled 1978-1995 using the 1982 revised criteria ACR82 (82acr). Results. The mean annual incidence of SLE was 3.00 for cohort 97acr (n = 58) versus 2.63 for cohort 82acr (n = 81) (p = 0.5). All patients in the 97acr cohort also fulfilled the 1982 criteria; however, significantly fewer patients presented with discoid rash [odds ratio (OR) 0.31)], arthritis (OR 0.24), renal (OR 0.28) or hematological disorder (OR 0.27), and significantly more with anti-dsDNA (OR 2.57) and antiphospholipid antibodies (OR 27.9). Initial treatment with intravenous pulse methylprednisolone (OR 9.23), azathioprine (OR 6.32), and low-dose aspirin (OR 20.9) was increased in cohort 97acr. Five-(95.2%) and 10-year survival (91.9%) rates were also improved for cohort 97acr. Conclusion. The ACR97 criteria set has construct validity compared to the ACR82 criteria set. SLE incidence remains unchanged in northern Norway, but a significant reduction of renal disease and further improvements in survival rates occurred simultaneously with increased serological surveillance with ELISA-based assays and early immunosuppressive and anticoagulant therapy.

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Section: Discussionsupporting

confidence: 91%

The Influence of the 1997 Updated Classification Criteria for Systemic Lupus Erythematosus: Epidemiology, Disease Presentation, and Patient Management

Eilertsen¹,

Becker-Merok²,

Nossent³

2009

J Rheumatol

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“…dence of systemic sclerosis (SSc; scleroderma) vary widely depending on the period of observation, methods of case ascertainment, and the geographic area of study (1)(2)(3)(4)(5)(6); for review, see ref. 7).…”

mentioning

confidence: 99%

Prevalence, incidence, survival, and disease characteristics of systemic sclerosis in a large US population

Mayes¹,

Lacey²,

Beebe‐Dimmer³

et al. 2003

Arthritis & Rheumatism

844

491

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Objective. To estimate the prevalence, incidence, survival, and disease characteristics of systemic sclerosis (SSc) in the Detroit tricounty area.Methods. A census of SSc cases for the period 1989-1991 was conducted in the Detroit area, using multiple sources for case identification. Diagnoses were verified by medical record review. Capture-recapture analysis was used to estimate the total SSc population. Cases of localized scleroderma (morphea and linear disease) were excluded.Results. Based on 706 verified cases of SSc, prevalence was initially estimated to be 242.0 cases per million adults (95% confidence interval [95% CI] 213-274), with an annual incidence of 19.3 new cases per million adults per year (95% CI 12.4-30.2). Capturerecapture analysis, based on the degree of overlap of verified cases among multiple sources, resulted in a revised prevalence estimate of 276 cases per million adults (95% CI 245-310). Sex-and race-specific prevalence estimates were significantly higher for women than for men, and for blacks than for whites. The average age at diagnosis was significantly younger for blacks than for whites. Compared with white patients, black patients were almost twice as likely to have diffuse disease (prevalence proportion ratio 1.86, 95% CI 1.48-2.35). Median survival was ϳ11 years. Factors negatively affecting survival included male sex (hazard ratio 1.81, 95% CI 1.29-2.55) and older age at diagnosis (hazard ratio 1.04, 95% CI 1.03-1.05).Conclusion. This study establishes baseline estimates of SSc occurrence and characteristics in a large US cohort consisting primarily of black adults and white adults. These data should facilitate research regarding the role of geographic, ethnic, racial, and environmental factors for this disease in comparison populations.

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“…Unfortunately, the available data concerning the incidence and prevalence of SLE are conflicting. A number of population-based studies have estimated the incidence of SLE in the United States, Europe, and the Caribbean (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). It is important to note that all these studies relied on reporting of cases through one or more sources of ascertainment rather than by population survey.…”

mentioning

confidence: 99%

Incidence of systemic lupus erythematosus race and gender differences

McCarty

Manzi

Medsger

et al. 1995

Arthritis & Rheumatism

371

241

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Objective. To examine racial differences in the incidence of systemic lupus erythematosus (SLE).Methods. A population-based registry of SLE patients in Allegheny County, Pennsylvania, was used to identify incident cases of SLE diagnosed between January 1, 1985 and December 31, 1990, from 3 sources, by medical record review (University of Pittsburgh Lupus Databank, rheumatologists, and hospitals). Capture recapture methods using log-linear models were used to estimate the level of case-finding and to calculate 95% confidence intervals (CI). Incidence rates were calculated per 100,000 population.Results. A total of 191 definite and 78 probable incident cases of SLE were identified, and the overall annual incidence rates were 2.4 (95% CI 2.1-2.8) and 1.0 (95% CI 0.8-1.3), respectively. The crude incidence rates of definite SLE were 0.4 for white males, 3.5 for white females, 0.7 for African-American males, and 9.2 for African-American females. The annual incidence rates of definite SLE remained fairly constant over the study interval. African-American females with definite SLE had a younger mean age at diagnosis compared with white females (P < 0.05). Since the overall ascertainment rate was high (85%; 95% CI 78-92%), the ascertainment-corrected incidence rate for definite SLE, 2.8 (95% CI 2.6-3.2), was similar to the crude rate.Conclusion. Our rates clearly confirm previous reports of an excess incidence of SLE among females compared with males and among African-Americans compared with whites. We have used capture-recapture methods to improve the accuracy of SLE incidence rates, and we advocate their use to facilitate comparisons across studies.Accurate determination of the incidence rates of systemic lupus erythematosus (SLE) is vital to understanding the clinical and societal consequences of this disease. Unfortunately, the available data concerning the incidence and prevalence of SLE are conflicting. A number of population-based studies have estimated the incidence of SLE in the United States, Europe, and the Caribbean (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). It is important to note that all these studies relied on reporting of cases through one or more sources of ascertainment rather than by population survey. Early epidemiologic investigations of SLE in the US provided important preliminary estimates of disease incidence and differences in incidence based on age, sex, and race (1,2,4). Although these studies indicated a predominance of SLE in women and an increased incidence in AfricanAmericans compared with whites, the reported rates within a given gender and within specific racial groups varied dramatically across geographic areas and over study periods within a geographic area.Recent European studies have included methodologic improvements (i.e., use of standardized case

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Epidemiology of Systemic Lupus Erythematosus and Other Connective Tissue Diseases in Rochester, Minnesota, 1950 Through 1979

Cited by 236 publications

References 15 publications

The Influence of the 1997 Updated Classification Criteria for Systemic Lupus Erythematosus: Epidemiology, Disease Presentation, and Patient Management

The Influence of the 1997 Updated Classification Criteria for Systemic Lupus Erythematosus: Epidemiology, Disease Presentation, and Patient Management

Prevalence, incidence, survival, and disease characteristics of systemic sclerosis in a large US population

Incidence of systemic lupus erythematosus race and gender differences

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