Feb 4, 2025 Story by: Editor
New NHS data indicates that Black individuals are eight times more likely than White individuals to be admitted to the hospital with lupus, with experts pointing to delayed diagnoses as a potential cause of this significant disparity.
In England, the hospital admission rate for Black patients diagnosed primarily with lupus stood at 62.6 per 100,000 people in 2023-24, compared to 7.8 per 100,000 for White patients. Asian patients also experienced higher hospitalization rates, with 26 admissions per 100,000 people.
Systemic lupus erythematosus (SLE), commonly known as lupus, is a chronic autoimmune disease in which the immune system mistakenly attacks healthy tissues and organs. The condition can lead to severe symptoms, including extreme fatigue, anemia, and even major organ failure.
The number of hospital-treated lupus cases has increased by 26% over the past four years, rising from 6,334 admissions in 2019-20 to 8,006 in 2023-24. These figures represent completed hospital admission episodes where lupus was the primary diagnosis.
In the UK, approximately one in 1,000 people have lupus, with women accounting for 90% of cases. While individuals from minority ethnic backgrounds face a higher risk of developing lupus, experts argue that this alone does not fully account for the stark differences in hospitalization rates.
Angela Davison of the Lupus Trust suggested that late diagnoses could be a major factor in these disparities, as they often lead to more severe symptoms. “These stark figures highlight how, despite lupus being much more prevalent in certain ethnic groups such as African, African-Caribbean and Asian, there is often far less awareness of it among these groups, which also contributes to a delay in diagnosis,” she said.
“We need more people to know about lupus and its symptoms and, in particular, for doctors to be familiar with it – specifically GPs as this is the first doctor that people will usually visit when symptoms appear.”
Dr. Faye Ruddock, chair of the Caribbean and African Health Network, emphasized the inadequate care and treatment received by Black women with lupus.
“There are significant determining factors that exacerbate the multiple organs affected in SLE such as racism, poor housing, poor healthcare and access to services, with later referral for appropriate treatment and care. All of these ongoing challenges lead to an eightfold higher rate of hospitalisation and the likelihood of black women dying from the condition,” Ruddock said.
She further stressed the need for urgent intervention to address these disparities. “There is an urgent need to focus on ways to address this inequity that is affecting the lives of many black people, their families, society and the economy. The 10-year plan should identify through the health inequalities and prevention agenda new ways of working with underserved communities to reduce risk and hospitalisation and with this build in the resource required to shift the dial.”
Prof. Anisur Rahman, a consultant rheumatologist at University College Hospital and a professor of rheumatology at UCL, acknowledged that lupus is more common among Black and Asian individuals but noted that this alone does not fully explain the hospitalization gap.
“Lupus occurs more commonly in black and Asian people than white people but this alone would not explain the increased hospitalisation in those groups. Research in the UK and elsewhere has suggested that lupus may be worse in black and Asian patients, which could lead them to become more ill from the disease and require hospitalisation.”
He also called for more research into why lupus disproportionately affects minority ethnic groups. “Although we know that SLE occurs more commonly in black and Caribbean ethnic groups than white people, this is not sufficient to explain all the difference in levels of hospitalisation.”
While lupus is believed to have a genetic component, Rahman noted that there are no specific genes that can fully account for the increased prevalence in minority ethnic communities. “Although it is assumed to be genetic in origin, there are no specific genes which can explain it, in comparison to other diseases which can be attributed to specific genes such as sickle cell disease.”
Prof. David D’Cruz, a consultant rheumatologist at Guy’s Hospital, described the higher hospitalization rate for Black patients as “concerning,” suggesting that it could be an indicator of more severe symptoms among this group.
“Although there have been advances in the early diagnosis and treatment of patients with SLE, this data suggests that there is a significant unmet need to improve disease activity, prevent disease flares and reduce the rate of hospital admissions,” D’Cruz said. “The assumption is that disease flares [which occur when symptoms get worse] requiring hospital admission can increase the risk of damage accumulation, which is known to increase the risk of morbidity and premature mortality.”
An NHS spokesperson commented on the findings, emphasizing the importance of early detection. “The causes of lupus are not fully understood but we know it is better managed and treated if found early, so anyone concerned that they may be experiencing symptoms should contact their GP in the first instance.” Source: The Guardian
