Health disparities in systemic lupus erythematosus-a narrative review.
Health disparities in systemic lupus erythematosus-a narrative review.
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DOI：
10.1007/s10067-022-06268-y
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发表时间：
2022-11
影响因子：
3.4
通讯作者：
中科院分区：
文献类型：
--
作者：
通过回顾与种族、种族、性别或社会经济差异相关的系统性红斑狼疮（SLE）发病率和结局的研究，描述健康差异的根本原因，并提出解决方案。在过去的40年里，SLE的结局稳步改善，但在不同种族和民族中的分布并不均匀。属于种族和少数民族被认为是SLE更严重疾病和不良结局的危险因素。基于人群的登记研究表明，黑人SLE患者的预期寿命显著低于白色患者。较低的社会经济地位已被证明是狼疮性肾炎进展为终末期肾病的最强预测因素之一。患者经历种族歧视、SLE活动增加和损害之间的关联也被描述。在狼疮临床试验中缺乏边缘化社区的代表性进一步延续了这些差异。为此，建立一支与其治疗的患者相似的风湿病学工作人员队伍的目标已经成为解决当前护理短缺的众多解决方案之一。SLE发病率、治疗和结局的差异现已得到充分证实。这些差异的根本原因是多因素的，包括遗传，表观遗传和社会经济。边缘化社区在狼疮临床试验中的代表性不足进一步加剧了这些差异。最近已作出努力，以更全面的方式解决不平等问题，但必须承认不平等的系统性原因，并需要有政治意愿来实现持续的积极变化。
To describe root causes of health disparities by reviewing studies on incidence and outcomes of systemic lupus erythematosus (SLE) related to ethnic, race, gender, or socioeconomic differences and to propose solutions. SLE outcomes have steadily improved over the past 40 years but are not uniformly distributed across various racial and ethnic groups. Belonging to racial and ethnic minority has been cited as a risk factor for more severe disease and poor outcome in SLE. Population-based registries have demonstrated that Black patients with SLE have significantly lower life expectancy compared to White patients. Lower socioeconomic status has been shown to be one of the strongest predictors of progression to end stage renal disease in lupus nephritis. An association between patient experiences of racial discrimination, increased SLE activity, and damage has also been described. The lack of representation of marginalized communities in lupus clinical trials further perpetuates these disparities. To that end, the goal of a rheumatology workforce that resembles the patients it treats has emerged as one of many solutions to current shortfalls in care. Disparities in SLE incidence, treatment, and outcomes have now been well established. The root causes of these disparities are multifactorial including genetic, epigenetic, and socioeconomic. The underrepresentation of marginalized communities in lupus clinical trials further worsen these disparities. Efforts have been made recently to address disparities in a more comprehensive manner, but systemic causes of disparities must be acknowledged and political will is required for a sustained positive change.
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影响因子：
3.4
作者：
Falasinnu, Titilola;Chaichian, Yashaar;Simard, Julia F.
通讯作者：
Simard, Julia F.
影响因子：
27.4
作者：
Bruce IN;O'Keeffe AG;Farewell V;Hanly JG;Manzi S;Su L;Gladman DD;Bae SC;Sanchez-Guerrero J;Romero-Diaz J;Gordon C;Wallace DJ;Clarke AE;Bernatsky S;Ginzler EM;Isenberg DA;Rahman A;Merrill JT;Alarcón GS;Fessler BJ;Fortin PR;Petri M;Steinsson K;Dooley MA;Khamashta MA;Ramsey-Goldman R;Zoma AA;Sturfelt GK;Nived O;Aranow C;Mackay M;Ramos-Casals M;van Vollenhoven RF;Kalunian KC;Ruiz-Irastorza G;Lim S;Kamen DL;Peschken CA;Inanc M;Urowitz MB
通讯作者：
Urowitz MB
狼疮护理和结果的差异。
影响因子：
5.1
作者：
Demas KL;Costenbader KH
通讯作者：
Costenbader KH
影响因子：
5
作者：
Falasinnu T;Chaichian Y;Bass MB;Simard JF
通讯作者：
Simard JF
影响因子：
2.6
作者：
Chehab, G.;Sauer, G. M.;Schneider, M.
通讯作者：
Schneider, M.