Overview of systemic lupus erythematosus (SLE) in adults
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect almost any organ and cause focal and systemic symptoms. The prevalence of SLE in Australasia ranges from 13 to 89 per 100 000 people, with prevalence at the higher end of the range reported in Aboriginal, Torres Strait Islander, Māori and Pacific peoplesBarber, 2021). Females are more commonly affected by SLE than males. SLE may develop at any age, but peak incidence is during childbearing years (females aged 15 to 45 years). For important reproductive health considerations for people with SLE, see Reproductive health in people with SLE.
For discussion of SLE in children and adolescents, see the separate topic SLE in children and adolescents.
The clinical course of SLE is often one of remission and relapse (flare). The prognosis of SLE depends on the nature and severity of organ involvement. People who present with, and continue to have, mild symptoms early in the disease are unlikely to progress to more severe disease. People with a younger age of onset and certain ethnic groups (eg Asian, Aboriginal and Torres Strait Islander peoples) have an increased risk of more severe disease.
Modern treatments have improved the 5-year survival of people with SLE to around 95%; however, the mortality rate is 1.8 times greater in people with SLE compared with age- and sex-matched populationsBultink, 2021. Atherosclerotic cardiovascular disease, infections and noninfectious respiratory disease are the major causes of mortality in people with SLEBultink, 2021. Early and regular review of risk factors for cardiovascular disease is crucial to improve outcomes for all people with SLEDrosos, 2022). For more detail, see Specific management for cardiovascular features of SLE.
Cutaneous lupus erythematosus is covered in the Dermatology guidelines.