Ethnic differences in disease activity among patients with systemic lupus erythematosus in a universal public healthcare system.

This article evaluates ethnic disparities among patients with systemic lupus erythematosus (SLE) treated within Spain's universal, publicly funded healthcare system by comparing clinical features, disease activity, and treatment between ethnically Spanish patients (Spaniards) and non-Spaniard patients (including Latin American, Asian, and African descent individuals) at a single tertiary hospital. The study found no significant ethnic differences in major clinical manifestations, renal histology, or use of immunosuppressive and biologic therapies. However, non-Spaniard patients exhibited higher disease activity scores (measured by SLEDAI-2K and SLE-DAS), lower remission rates according to the Definitions Of Remission In SLE (DORIS) criteria, and greater glucocorticoid (prednisone) use, suggesting intrinsic disease variation rather than disparities in healthcare access or treatment. These findings indicate that equitable healthcare delivery may mitigate many ethnic outcome differences, though biological or genetic factors could underlie variations in disease expression.