Systemic lupus erythematosus in Asia: Is it more common and more severe?

Abstract

Aim: We summarized published data on prevalence and comparative disease manifestations of systemic lupus erythematosus (SLE) to determine if SLE is more common or more severe in Asians compared with Caucasians. Methods: A PubMed search was used to identify studies reporting prevalence or clinical manifestations (limited to comparative studies in multi-ethnic Asian populations or between Asians and Caucasians) of SLE among Asians. Results: We identified 18 studies of prevalence and six studies of comparative disease manifestations and/or prevalence (from 1725 retrieved abstracts). Prevalence (per 100,000) of SLE in community-based studies ranged from 3.2 to 70.4 in Asian studies and 46.7-161.0 in Asian migrant studies compared with 20.6-78.5 in North America and 24.6-91.0 in Europe. Studies in Asian migrants showed double the prevalence of SLE among Indians (2/2 studies) and Chinese (1/2 studies) as compared with Caucasians. Two studies found differences in clinical manifestations of SLE among Chinese, Malays and Indians living in the same country. Four comparative studies variously found more renal, central nervous system or other major organ involvement among Asians and Asian migrants than Caucasians with SLE over the disease course. Conclusions: SLE is generally not more prevalent in Asian than Caucasian populations, although it is more prevalent among Asian migrants. SLE has more severe clinical manifestations among Asians compared with Caucasians. © 2006 Asia Pacific League of Associations for Rheumatology.