Objective
Systemic lupus erythematosus (SLE), a chronic multisystem autoimmune disease with a wide spectrum of manifestations, shows considerable variation across the globe, although there is little evidence to indicate its relative prevalence in Asia. This review describes its prevalence, severity, and outcome across countries in the Asia-Pacific region.

Methods
We conducted a systematic literature search using 3 groups of terms (SLE, epidemiology, and Asia-Pacific countries) of EMBase and PubMed databases and non–English language resources, including Chinese Wanfang, Korean KMbase, Korean College of Rheumatology, Japana Centra Revuo Medicina, Taiwan National Digital Library of Theses and Dissertations, and Taiwanese, Thai, and Vietnamese journals.

Results
The review showed considerable variation in SLE burden and survival rates across Asia-Pacific countries. Overall crude incidence rates (per 100,000 per year) ranged from 0.9–3.1, while crude prevalence rates ranged from 4.3–45.3 (per 100,000). Higher rates of renal involvement, one of the main systems involved at death, were observed for Asians (21–65% at diagnosis and 40–82% over time) than for whites. While infections and active SLE were leading causes of death, a substantial proportion (6–40%) of deaths was due to cardiovascular involvement. The correlation between the Human Development Index and 5-year survival was 0.83.

Conclusion
This review highlights the need to closely monitor Asian SLE patients in Asian countries for renal and cardiovascular involvement, especially those who may not receive proper treatment and are therefore at greater risk of severe disease. We hope this will encourage further research specific to this region and lead to improved clinical management.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/acr.20683

Systematic review of the epidemiology of systemic lupus erythematosus in the Asia-Pacific region: prevalence, incidence, clinical features, and mortality.

Objective: It is known that age at disease onset has an impact on the clinical course andoutcome of systemic lupus erythematosus (SLE); however, the precise differences in theprevalence of SLE manifestations are debated. Our objective was to conduct a systematicliterature review and meta-analysis of all studies that directly compare childhood-onset lupus with adult-onsetlupus to determine which clinical manifestations vary with age at disease onset. Methods: A comprehensive literature search of the MEDLINE/PubMed,EMBASE, CINAHL, and SCOPUS databases was conducted to identify relevant articles. Study quality was assessed using the STROBE checklist. Study sample characteristics and clinical manifestation event rates were extracted from each study. Pooled odds ratios (ORs) were calculated using the random effects method, and between-study heterogeneity was quantified using the I2 statistic. Results: Of the 484studies identified by the search strategy, 16 were included in this review. The total number of pati...

Differences in clinical manifestations between childhood-onset lupus and adult-onset lupus: a meta-analysis.

Differences in clinical features observed between childhood-onset versus adult-onset systemic lupus erythematosus: A systematic review and meta-analysis.

Giornale italiano di Dermatologia e Venereologia

Impact of sex disparities on the clinical manifestations in patients with systemic lupus erythematosus: A systematic review and meta-analysis.

To investigate the association of anti-Sm antibodies with clinical and serological features in systemic lupus erythematosus. A group of 1,584 patients with SLE was recruited. Clinical and laboratory data were compared between patients with and without anti-Sm antibodies. There were 1,424 females and 160 males, the mean age of the patients was 33.2 ± 12.3 years, and the mean duration of disease was 32.5 ± 59.4 months. A total of 469 (29.6%) were anti-Sm antibodies positive. The presence of anti-Sm antibodies was associated with arthritis, renal involvement, malar rash, vasculitis and low serum complement C3. The positive rate of anti-nuclear, anti-dsDNA, anti-La/SSB and anti-U1RNP antibodies were significant higher in anti-Sm positive group when compared with anti-Sm negative group. A trend towards a higher presence of anti-Sm antibodies related to an early disease onset was observed. In conclusion, Anti-Sm antibodies are associated with lupus related clinical and laboratory profiles and correlated significantly with disease activity.

Clinical and serological correlates of anti-Sm autoantibodies in Chinese patients with systemic lupus erythematosus: 1,584 cases

This study aims to review the cumulative clinical and laboratory data of 1,790 Chinese patients with systemic lupus erythematosus. Data were compared separately between male and female patients for each disease onset age groups and among three disease onset age groups in male and female patients. The ratio of female to male was 9.2:1, with differences among three age groups. There was no difference in mean age at onset between females and males. But diagnosis delay in male patients is shorter than in females. When compared with females, in adult-onset patients, males presented more frequently with serositis, pleuritis and discoid rash, but less frequently with malar rash, alopecia, oral ulcers, elevated erythrocyte sedimentation rate, anti-nuclear, anti-SSA and anti-SSB antibodies. In younger-onset group, males have less discoid rash. In older-onset group, males have less anti-SSA antibodies. In male patients, only anti-SSB antibodies were different in three age groups and negatively correlate to age. Among female patients, age had negative correlations with malar rash, discoid rash, photosensitivity, anti-dsDNA, anti-Sm, anti-SSB and anti-rRNP antibodies, but positive correlation with leucopenia. We conclude that women of childbearing age possess a distinct clinical and laboratory profile. In addition, differences in disease manifestations seem to be correlated with female sex hormones rather than age.

Gender and age influence on clinical and laboratory features in Chinese patients with systemic lupus erythematosus: 1,790 cases

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Clinical and serological correlates of anti-Sm autoantibodies in Chinese patients with systemic lupus erythematosus: 1,584 cases

Gender and age influence on clinical and laboratory features in Chinese patients with systemic lupus erythematosus: 1,790 cases