Barber Megan R W, Clarke Ann E
aDepartment of Medicine bDivision of Rheumatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Alberta, Canada.
Curr Opin Rheumatol. 2017 Sep;29(5):480-485. doi: 10.1097/BOR.0000000000000416.
The present review addresses recent literature investigating the socioeconomic consequences of systemic lupus erythematosus (SLE). We highlight the latest updates on health disparities affecting the SLE population, the direct and indirect economic costs of the disease, and less quantifiable costs such as reduced health-related quality of life (HRQoL).
Health disparities continue to exist among socially disadvantaged populations, including African Americans, Hispanics, and patients with decreased educational attainment and in poverty. Direct and indirect costs are substantial. Recent work provides updated cost estimates for patients with SLE outside of North America, including those in developing countries. Previous research has largely focused on costs of the general SLE population and those with renal manifestations or active SLE, whereas recent research addresses special populations such as hospitalized and pregnant patients and glucocorticoid users. Patients with SLE and their caregivers experience a substantially reduced HRQoL.
SLE is a costly disease that disproportionately affects disadvantaged populations. Future economic studies should measure not only direct costs, but also incorporate indirect costs and the HRQoL of both patients with SLE and their caregivers. All these components are essential to provide a comprehensive assessment of the socioeconomic consequences of SLE and an appreciation of the potential impact of novel therapies.
本综述探讨了近期有关系统性红斑狼疮（SLE）社会经济后果的文献。我们重点介绍了影响SLE患者群体的健康差异、该疾病的直接和间接经济成本，以及诸如健康相关生活质量（HRQoL）降低等难以量化的成本的最新情况。
社会弱势群体，包括非裔美国人、西班牙裔、受教育程度较低和贫困患者中，健康差异仍然存在。直接和间接成本巨大。近期研究提供了北美以外SLE患者的最新成本估计，包括发展中国家的患者。以往研究主要关注SLE总体人群以及有肾脏表现或活动性SLE患者的成本，而近期研究涉及住院患者、孕妇和糖皮质激素使用者等特殊人群。SLE患者及其照料者的HRQoL大幅降低。
SLE是一种成本高昂的疾病，对弱势群体的影响尤为严重。未来的经济研究不仅应衡量直接成本，还应纳入间接成本以及SLE患者及其照料者的HRQoL。所有这些要素对于全面评估SLE的社会经济后果以及理解新疗法的潜在影响至关重要。
