Lupus characteristics and progression differ among racial/ethnic groups

In the first epidemiologic study comparing lupus among four major racial/ethnic groups, researchers found that, following a lupus diagnosis, Blacks, Asians/Pacific Islanders, and Hispanics are at increased risk of developing problems related to the kidneys, the neurological system, and the blood. The findings are published in Arthritis Care & Research.

By analyzing data from the California Lupus Surveillance Project (CLSP), a large population-based registry of individuals with lupus living in San Francisco County, investigators uncovered important differences in the characteristics and progression of lupus between racial/ethnic minority groups and whites.

The findings highlight the importance of increased awareness of lupus and its accelerated progression in certain racial/ethnic groups, and they point to the need for greater efforts to support early diagnosis and treatment in these populations.

"It has been well established that for many chronic diseases such as diabetes and hypertension, minority groups in the United States tend to have poorer overall outcomes as a result of multilevel influences, broadly categorized as patient level factors—such as biology, adherence, discrimination—as well as socioeconomic, health policy, and health care level factors," said lead author Dr. Ernest Maningding, of the University of California, San Francisco. "In lupus, disparities in health outcomes are striking and affect all of the major racial/ethnic groups in the United States. Alleviating these racial/ethnic disparities requires a multilevel approach, and as providers we need to be more vigilant about new symptoms in these patients and ensure communication that is culturally competent and breeds trust."

Dr. Mandingding noted that the analysis of genetic and other biologic data would have been useful if collected previously for this study population. "We believe genetic differences may predispose various populations to developing lupus and predict poorer prognosis, and thus a longitudinal study called the California Lupus Epidemiology Surveillance Study, or CLUES, is underway, and we are collecting biologic specimens voluntarily provided by members of the CLSP cohort," he said.