Reppe Moe Sigrid, Haukeland Hilde, Molberg Øyvind, Lerang Karoline
Department of Rheumatology, Oslo University Hospital, 0424 Oslo, Norway.
Department of Rheumatology, Martina Hansens Hospital, 1346 Gjettum, Norway.
J Clin Med. 2021 Sep 22;10(19):4306. doi: 10.3390/jcm10194306.
Accurate knowledge of outcomes in Systemic Lupus Erythematosus (SLE) is crucial to understanding the true burden of the disease. The main objective of this systematic review was to gather all population-based studies on mortality, end-stage renal disease (ESRD) and cancer in SLE.
We performed a systematic literature search in two electronic databases (MEDLINE and Embase) to identify all population-based articles on SLE and survival, mortality, ESRD and cancer. The SLE diagnosis had to be verified. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA).
We included 40/1041 articles on mortality (27), ESRD (11) and cancer (3), of which six were defined as inception studies. In the total SLE cohort, the standardized mortality ratio ranged from 1.9 to 4.6. Cardiovascular disease was the most frequent cause of death in studies with follow-up times over 15 years. SLE progressed to ESRD in 5-11% of all SLE patients. There are no data supporting increased cancer incidence from population-based inception cohorts.
There is a need for more population-based studies on outcomes of SLE, especially inception studies, with the use of control groups and follow-up times over 15 years.
准确了解系统性红斑狼疮（SLE）的预后对于理解该疾病的真正负担至关重要。本系统评价的主要目的是收集所有基于人群的关于SLE患者死亡率、终末期肾病（ESRD）和癌症的研究。
我们在两个电子数据库（MEDLINE和Embase）中进行了系统的文献检索，以识别所有基于人群的关于SLE及生存、死亡率、ESRD和癌症的文章。SLE诊断必须得到验证。我们采用了系统评价和Meta分析的首选报告项目（PRISMA）指南。
我们纳入了1041篇文章中的40篇，涉及死亡率（27篇）、ESRD（11篇）和癌症（3篇），其中6篇被定义为起始队列研究。在整个SLE队列中，标准化死亡率在1.9至4.6之间。在随访时间超过15年的研究中，心血管疾病是最常见的死亡原因。5-11%的SLE患者病情进展为ESRD。没有数据支持基于人群的起始队列中癌症发病率增加。
需要开展更多基于人群的关于SLE预后的研究，尤其是起始队列研究，采用对照组且随访时间超过15年。
