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Long-Term Survival and Death Causes of Systemic Lupus Erythematosus in China: A Systemic Review of Observational Studies

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with an increased risk of death compared to general population. Although previous studies showed improvement in survival of SLE, the long-term prognosis has not been elaborated in China. This study aims to integrate the observational...

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Autores principales: Wang, Ziqian, Wang, Yanhong, Zhu, Rongrong, Tian, Xinping, Xu, Dong, Wang, Qian, Wu, Chanyuan, Zhang, Shangzhu, Zhao, Jiuliang, Zhao, Yan, Li, Mengtao, Zeng, Xiaofeng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603034/
https://www.ncbi.nlm.nih.gov/pubmed/25929930
http://dx.doi.org/10.1097/MD.0000000000000794
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author Wang, Ziqian
Wang, Yanhong
Zhu, Rongrong
Tian, Xinping
Xu, Dong
Wang, Qian
Wu, Chanyuan
Zhang, Shangzhu
Zhao, Jiuliang
Zhao, Yan
Li, Mengtao
Zeng, Xiaofeng
author_facet Wang, Ziqian
Wang, Yanhong
Zhu, Rongrong
Tian, Xinping
Xu, Dong
Wang, Qian
Wu, Chanyuan
Zhang, Shangzhu
Zhao, Jiuliang
Zhao, Yan
Li, Mengtao
Zeng, Xiaofeng
author_sort Wang, Ziqian
collection PubMed
description Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with an increased risk of death compared to general population. Although previous studies showed improvement in survival of SLE, the long-term prognosis has not been elaborated in China. This study aims to integrate the observational studies estimating current long-term survival of Chinese SLE patients and analyze the death-cause situation of SLE in China. The study is a systemic review of English and non-English articles using MEDLINE, EMBASE, CNKI, WANFANG, and SINOMED databases. Additional studies were found by consultation with clinical experts, browse of references in selected papers, and search of related textbooks. Our major search terms were SLE, follow-up, prognosis, survival, mortality, and China. We included cohort studies for survival analysis, and both cohort studies and case series for death-cause analysis in China. The extraction of the articles were done by 2 authors independently using predesigned charts, including characteristics of study, clinical data, analyzing data, and study quality indicators. All pooled analyses were conducted both for random-effects model and fixed-effects model. Funnel plots and Egger regression tests were applied to check potential publication bias. Heterogeneity was tested by sensitivity analysis. We identified 5 studies for survival analysis comprising 4469 Chinese patients with SLE (380 observed deaths). Thirty-six studies were suitable for death-cause analysis with 2179 observed deaths (derived from more than 20,000 Chinese patients with SLE). The overall pooled survival rates for SLE in China were 94% for 5-year survival rate and 89% for 10-year survival rate after disease onset from the year 1995 to 2013, which were similar with previous publications in Asia-Pacific area. The proportions of different causes of death showed infection (33.2%), renal involvement (18.7%), lupus encephalopathy (13.8%), and cardiovascular disease (11.5%) as the top 4 causes. The overall survival rates for Chinese patients with SLE resembled previous publications in Asia-Pacific area. But the death causes of SLE in China were of some differences indicating relatively higher proportion of infection and lupus encephalopathy and lower cardiovascular disease. Ethnicity and more aggressive treatment might have contributed to the difference in death composition.
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spelling pubmed-46030342015-10-27 Long-Term Survival and Death Causes of Systemic Lupus Erythematosus in China: A Systemic Review of Observational Studies Wang, Ziqian Wang, Yanhong Zhu, Rongrong Tian, Xinping Xu, Dong Wang, Qian Wu, Chanyuan Zhang, Shangzhu Zhao, Jiuliang Zhao, Yan Li, Mengtao Zeng, Xiaofeng Medicine (Baltimore) 6900 Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with an increased risk of death compared to general population. Although previous studies showed improvement in survival of SLE, the long-term prognosis has not been elaborated in China. This study aims to integrate the observational studies estimating current long-term survival of Chinese SLE patients and analyze the death-cause situation of SLE in China. The study is a systemic review of English and non-English articles using MEDLINE, EMBASE, CNKI, WANFANG, and SINOMED databases. Additional studies were found by consultation with clinical experts, browse of references in selected papers, and search of related textbooks. Our major search terms were SLE, follow-up, prognosis, survival, mortality, and China. We included cohort studies for survival analysis, and both cohort studies and case series for death-cause analysis in China. The extraction of the articles were done by 2 authors independently using predesigned charts, including characteristics of study, clinical data, analyzing data, and study quality indicators. All pooled analyses were conducted both for random-effects model and fixed-effects model. Funnel plots and Egger regression tests were applied to check potential publication bias. Heterogeneity was tested by sensitivity analysis. We identified 5 studies for survival analysis comprising 4469 Chinese patients with SLE (380 observed deaths). Thirty-six studies were suitable for death-cause analysis with 2179 observed deaths (derived from more than 20,000 Chinese patients with SLE). The overall pooled survival rates for SLE in China were 94% for 5-year survival rate and 89% for 10-year survival rate after disease onset from the year 1995 to 2013, which were similar with previous publications in Asia-Pacific area. The proportions of different causes of death showed infection (33.2%), renal involvement (18.7%), lupus encephalopathy (13.8%), and cardiovascular disease (11.5%) as the top 4 causes. The overall survival rates for Chinese patients with SLE resembled previous publications in Asia-Pacific area. But the death causes of SLE in China were of some differences indicating relatively higher proportion of infection and lupus encephalopathy and lower cardiovascular disease. Ethnicity and more aggressive treatment might have contributed to the difference in death composition. Wolters Kluwer Health 2015-05-01 /pmc/articles/PMC4603034/ /pubmed/25929930 http://dx.doi.org/10.1097/MD.0000000000000794 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 6900
Wang, Ziqian
Wang, Yanhong
Zhu, Rongrong
Tian, Xinping
Xu, Dong
Wang, Qian
Wu, Chanyuan
Zhang, Shangzhu
Zhao, Jiuliang
Zhao, Yan
Li, Mengtao
Zeng, Xiaofeng
Long-Term Survival and Death Causes of Systemic Lupus Erythematosus in China: A Systemic Review of Observational Studies
title Long-Term Survival and Death Causes of Systemic Lupus Erythematosus in China: A Systemic Review of Observational Studies
title_full Long-Term Survival and Death Causes of Systemic Lupus Erythematosus in China: A Systemic Review of Observational Studies
title_fullStr Long-Term Survival and Death Causes of Systemic Lupus Erythematosus in China: A Systemic Review of Observational Studies
title_full_unstemmed Long-Term Survival and Death Causes of Systemic Lupus Erythematosus in China: A Systemic Review of Observational Studies
title_short Long-Term Survival and Death Causes of Systemic Lupus Erythematosus in China: A Systemic Review of Observational Studies
title_sort long-term survival and death causes of systemic lupus erythematosus in china: a systemic review of observational studies
topic 6900
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603034/
https://www.ncbi.nlm.nih.gov/pubmed/25929930
http://dx.doi.org/10.1097/MD.0000000000000794
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