TY - JOUR
T1 - Systemic lupus erythematosus in Aboriginal and Torres Strait Islander peoples in Australia
T2 - addressing disparities and barriers to optimising patient care
AU - Eades, Laura E.
AU - Hoi, Alberta Y.
AU - Liddle, Ruaidhri
AU - Sines, Jason
AU - Kandane-Rathnayake, Rangi
AU - Khetan, Sachin
AU - Nossent, Johannes
AU - Lindenmayer, Greta
AU - Morand, Eric F.
AU - Liew, David F.L.
AU - Rischmueller, Maureen
AU - Brady, Stephen
AU - Brown, Alex
AU - Vincent, Fabien B.
PY - 2024/10
Y1 - 2024/10
N2 - The first inhabitants of Australia and the traditional owners of Australian lands are the Aboriginal and Torres Strait Islander peoples. Aboriginal and Torres Strait Islander peoples are two to four times more likely to have systemic lupus erythematosus (SLE) than the general Australian population. Phenotypically, SLE appears distinctive in Aboriginal and Torres Strait Islander peoples and its severity is substantially increased, with mortality rates up to six times higher than in the general Australian population with SLE. In particular, Aboriginal and Torres Strait Islander peoples with SLE have increased prevalence of lupus nephritis and increased rates of progression to end-stage kidney disease. The reasons for the increased prevalence and severity of SLE in this population are unclear, but socioeconomic, environmental, and biological factors are all likely to be implicated, although there are no published studies investigating these factors in Aboriginal and Torres Strait Islander peoples with SLE specifically, indicating an important knowledge gap. In this Review, we summarise the data on the incidence, prevalence, and clinical and biological findings relating to SLE in Aboriginal and Torres Strait Islander peoples and explore potential factors contributing to its increased prevalence and severity in this population. Importantly, we identify health disparities and deficiencies in health-care provision that limit optimal care and outcomes for many Aboriginal and Torres Strait Islander peoples with SLE and highlight potentially addressable goals to improve outcomes.
AB - The first inhabitants of Australia and the traditional owners of Australian lands are the Aboriginal and Torres Strait Islander peoples. Aboriginal and Torres Strait Islander peoples are two to four times more likely to have systemic lupus erythematosus (SLE) than the general Australian population. Phenotypically, SLE appears distinctive in Aboriginal and Torres Strait Islander peoples and its severity is substantially increased, with mortality rates up to six times higher than in the general Australian population with SLE. In particular, Aboriginal and Torres Strait Islander peoples with SLE have increased prevalence of lupus nephritis and increased rates of progression to end-stage kidney disease. The reasons for the increased prevalence and severity of SLE in this population are unclear, but socioeconomic, environmental, and biological factors are all likely to be implicated, although there are no published studies investigating these factors in Aboriginal and Torres Strait Islander peoples with SLE specifically, indicating an important knowledge gap. In this Review, we summarise the data on the incidence, prevalence, and clinical and biological findings relating to SLE in Aboriginal and Torres Strait Islander peoples and explore potential factors contributing to its increased prevalence and severity in this population. Importantly, we identify health disparities and deficiencies in health-care provision that limit optimal care and outcomes for many Aboriginal and Torres Strait Islander peoples with SLE and highlight potentially addressable goals to improve outcomes.
UR - http://www.scopus.com/inward/record.url?scp=85198702629&partnerID=8YFLogxK
U2 - 10.1016/S2665-9913(24)00095-X
DO - 10.1016/S2665-9913(24)00095-X
M3 - Review article
C2 - 38971169
AN - SCOPUS:85198702629
SN - 2665-9913
VL - 6
SP - e713-e726
JO - The Lancet Rheumatology
JF - The Lancet Rheumatology
IS - 10
ER -