Lower socioeconomic status worsens outcome of patients with systemic lupus erythematosus independently of access to healthcare

By Scott Cunningham, MD, PhD
Published March 29, 2022

Key Takeaways

  • Low socioeconomic status is associated with worse outcomes in patients with systemic lupus erythematosus, even within health systems with equal access to all.

Although it is known that low socioeconomic status (SES) negatively impacts outcomes in patients with systemic lupus erythematosus (SLE), it is not known if such an association exists in patients covered by a national health insurance plan.

Why This Study Matters

Policymakers need to be aware of the barriers to access and receipt of quality healthcare among patients with chronic diseases, such as SLE.

Study Design

A retrospective study was conducted to determine the impact of SES on health outcomes in patients with SLE. The patients were grouped according to SES (lower 25th, middle 25th-75th, and upper 75th quantiles).

The primary outcomes were all-cause mortality, development of end-stage kidney disease (ESKD), and a score < 4 on the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI 2 K < 4).

Results and Conclusions

A total of 617 patients with SLE (548 females [88.8%]) were followed for a median of 15 years. The lower SES group had a younger age of SLE onset when compared to the middle and higher SES groups (31.5 vs. 34.3 and 37.4 years, respectively).

In addition, the lupus nephritis rate was higher in the lower SES group (42.7% vs. 35.7% and 23.8%, respectively). Patients in the middle and higher SES groups had lower risks of mortality (HR = 0.45) and ESKD (HR = 0.24). No differences in the SLEDAI 2K < 4 were detected among the groups (OR = 1.49).

Related Research

Consider these findings from similar research studies:

  • Gender, race, and SES have a significant impact on health outcomes in patients with SLE (Source).

  • SLE severity and course are associated with ethnicity, income, education, and health insurance status (Source).

Original Source

Sagy I, Cohen Y, Nahum Y, Pokroy-Shapira E, Abu-Shakra M, Molad Y. Lower socioeconomic status worsens outcome of patients with systemic lupus erythematosus independently of access to healthcareLupus. Published online March 27, 2022:096120332210845.

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