Systemic Lupus Erythematosus Mortality Among Decedents Aged ≥15 Years—United States, 2018–2023

OBJECTIVE: Systemic lupus erythematosus (SLE) is a chronic autoimmune condition that can lead to death. To examine SLE as an underlying and contributing cause of death, the Centers for Disease Control and Prevention (CDC) analyzed 2018 to 2023 mortality data for persons aged ≥15 years overall and by age, sex, race and ethnicity, and region. METHODS: Death certificate data for persons aged ≥15 years with any mention of SLE (International Classification of Diseases, Tenth Revision [ICD-10] code M32) were analyzed using the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) system. We calculated age-adjusted death rates and assessed patterns by sex, age, race and ethnicity, and region. Underlying and contributing causes of death were evaluated using ranked cause-of-death lists and ICD-10 subchapters. RESULTS: During 2018 to 2023, 14,936 deaths had any mention of SLE listed on the death certificates. Of these deaths, 6,414 (42.9%) listed SLE as the underlying cause. The age-adjusted SLE mortality rate per million population was greater among females (5.97) than males (1.16), non-Hispanic African American persons (10.70) than persons of other non-Hispanic racial groups (range 2.46-5.62), Hispanic persons (3.98) than non-Hispanic persons (3.59), and people in the South (4.37) than people in other regions. When SLE was listed as a contributing cause of death, the leading underlying causes were heart disease (0.93), cancer (0.56), and COVID-19 (0.51). The overall age-adjusted SLE mortality rates were significantly higher in 2020 and 2021 than in all other study years, indicating the likely impact of the COVID-19 pandemic on SLE mortality. CONCLUSION: Overall management of SLE, comorbidities, and infections in patients with SLE, as well as interventions targeting groups (eg, African American persons) disproportionately impacted by SLE, may reduce overall SLE mortality.