Sep. 11, 2017

Lupus Impacts Asian/Pacific Islanders and Hispanics at Alarming Rates

Newly published analyses from two Centers for Disease Control and Prevention (CDC)-supported population-based registries in New York City and San Francisco show that Asian/Pacific Islanders and Hispanics of any race are more likely to be affected by the autoimmune disease lupus, compared with Whites (regardless of Hispanic ethnicity).

The analyses also show that lupus-related kidney disease (lupus nephritis) — a potentially fatal complication — appears to be more common among non-Hispanic Asians and Hispanics (of any race) compared with non-Hispanic Whites. 

These are the first population-based registries in the U.S. with a sufficient number of Asians and Hispanics to measure the incidence and prevalence of diagnosed systemic lupus erythematosus (lupus).

Data from these registries also confirmed an increase in lupus diagnoses among African American women, underscoring health disparities by race and ethnicity identified through previous population-based studies. Both analyses were published in the journal, Arthritis & Rheumatology

These just-released studies were led by Peter Izmirly, MD, Assistant Professor of Medicine at the NYU School of Medicine and Maria Dall’Era, MD, Professor of Medicine, Director of the Lupus Clinic and Director of the Rheumatology Clinical Research Center at the University of California, San Francisco.

“The population data from this Manhattan Lupus Surveillance Program, which includes Asians and Hispanics, groups where data are limited, substantiates our clinical impressions that more non-Whites have lupus than Whites, but they also have a higher burden of lupus manifestations,” said Dr. Izmirly. “Based on our data, 50 percent of non-White cases developed lupus nephritis, one of the most serious and disabling manifestations of the disease, compared with 25 percent of Whites.”

“The California Lupus Surveillance Project confirmed striking racial and ethnic disparities in the incidence and prevalence of lupus with the highest burden of disease in Black women, followed by Hispanic, Asian, and White women,” said Dr. Dall’Era.  “With a substantial number of Asian and Hispanic patients in San Francisco County, we were able to determine credible estimates of disease burden in these understudied populations.”

This research has shed further light on the variability of this disease and the need to understand the biology better, said Dr. Gary Gilkeson, Professor of Medicine at the Medical University of South Carolina and chair of the Lupus Foundation of America Medical-Scientific Advisory Council. “A one-size fits all approach to research in lupus will not work. This study shows us that.”

Lupus is a very complex disease and there are challenges associated with capturing all cases of lupus within a specified geographic region that may be managed across a broad spectrum of physicians and medical specialists. Consequently, not all providers that may have had patients with lupus participated in the registry and complete data for every patient was not available for all cases reviewed, resulting in possible underestimation.

“There is no one laboratory test that can be used to diagnose lupus, which makes it a challenging disease to understand,” said Hilary Parton, MLSP Principal Investigator at the NYC Department of Health and Mental Hygiene. “Our work on this registry has drawn from a variety of sources to provide a better understanding of lupus across racial and ethnic groups.”

The Manhattan and San Francisco registries are part of the National Lupus Patient Registries supported by CDC.  “We are working to learn more about lupus through our follow-up studies of affected women and men,” said Charles G. Helmick, MD, a medical epidemiologist with CDC. “We hope these studies will result in better interventions for those with lupus.”

For more details, you can access the abstracts online here:
The Manhattan Lupus Surveillance Program
The California Lupus Surveillance Project