{
  "abstract": "Background Systemic lupus erythematosus (SLE) shows marked heterogeneity in epidemiology across regions and over time. Understanding temporal changes in incidence, prevalence and patient characteristics is important to interpreting disease burden and assessing the performance of care systems.Objectives To evaluate changes after 12 years (2010 vs 2022) in epidemiology, demographic, clinical and therapeutic features of SLE in a general practitioner (GP)-based cohort in Tuscany, Italy.Methods We conducted two cross-sectional surveys among GPs in the Florence District (Tuscany, Italy) to identify SLE cases. We assessed temporal variations in incidence and prevalence rates, as well as in sociodemographic, clinical and treatment variables.Results SLE incidence doubled from 2010 to 2022, from 5.4 to 10.9 per 100 000 person-years; prevalence increased from 75 to 120 per 100 000 persons. Most diagnoses remained in adults aged 18–60, though non-negligible proportions had paediatric or late onset. Joint, skin and haematological involvement were most frequent, while renal involvement declined from 22% to 16%. Use of biologic therapies grew substantially over time, while glucocorticoids remained pivotal in management. Notably, the proportion of patients not receiving any treatment (glucocorticoids included) increased, indicating a shift towards glucocorticoid-sparing strategies. Furthermore, despite 12 years of demographic change in the general population, the ethnic composition of the SLE cohort remained largely stable, with most patients of Caucasian origin.Conclusions Over a decade, this GP-based study shows an increase in SLE prevalence and incidence within participating practices, accompanied by evolving therapeutic strategies and an increasing proportion of patients off treatment, including glucocorticoids. These findings have implications for health planning and support the value of GP-based epidemiologic studies.",
  "authors": [
    {
      "affiliations": [
        "Department of Medical, Surgery and Health Sciences, University of Trieste, Italy and Clinical Medicine and Rheumatology Unit, Cattinara University Hospital, Trieste, Italy"
      ],
      "name": "Michela Gasparotto"
    },
    {
      "affiliations": [
        "Department of Medical, Surgery and Health Sciences, University of Trieste, Italy and Clinical Medicine and Rheumatology Unit, Cattinara University Hospital, Trieste, Italy"
      ],
      "name": "Irene Mattioli"
    },
    {
      "affiliations": [
        "Department of General Practice, Local Health Unit Toscana Centro, Florence, Italy"
      ],
      "name": "Elisabetta Alti"
    },
    {
      "affiliations": [
        "Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy"
      ],
      "name": "Edoardo Biancalana"
    },
    {
      "affiliations": [
        "Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy"
      ],
      "name": "Maria Canfora"
    },
    {
      "affiliations": [
        "Department of Medical, Surgery and Health Sciences, University of Trieste, Italy and Clinical Medicine and Rheumatology Unit, Cattinara University Hospital, Trieste, Italy"
      ],
      "name": "Emanuele Chiara"
    },
    {
      "affiliations": [
        "Nephrology and Dialysis Unit of Trieste, Cattinara Univeristy Hospital, Trieste, Italy"
      ],
      "name": "Vittorio Di Maso"
    },
    {
      "affiliations": [
        "Department of Medical, Surgery and Health Sciences, University of Trieste, Italy and Clinical Medicine and Rheumatology Unit, Cattinara University Hospital, Trieste, Italy"
      ],
      "name": "Giulia Duro"
    },
    {
      "affiliations": [
        "General Medicine II, San Paolo Hospital, ASST Santi Paolo e Carlo, Univeristy of Milan, Milan, Italy"
      ],
      "name": "Amos Ferraro"
    },
    {
      "affiliations": [
        "Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy"
      ],
      "name": "Mariapaola Lisi"
    },
    {
      "affiliations": [
        "Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy"
      ],
      "name": "Danilo Malandrino"
    },
    {
      "affiliations": [
        "Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy"
      ],
      "name": "Miki Palmerini"
    },
    {
      "affiliations": [
        "Department of Medical, Surgery and Health Sciences, University of Trieste, Italy and Clinical Medicine and Rheumatology Unit, Cattinara University Hospital, Trieste, Italy"
      ],
      "name": "Maria Letizia Urban"
    },
    {
      "affiliations": [
        "Department of Medical, Surgery and Health Sciences, University of Trieste, Italy and Clinical Medicine and Rheumatology Unit, Cattinara University Hospital, Trieste, Italy"
      ],
      "name": "Lorenzo Vrola"
    },
    {
      "affiliations": [
        "Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy"
      ],
      "name": "Elena Silvestri"
    },
    {
      "affiliations": [
        "Department of Biomedical Experimental and Clinical Sciences \"Mario Serio\", University of Florence, Florence, Italy"
      ],
      "name": "Alessandra Bettiol"
    },
    {
      "affiliations": [
        "Department of Medical, Surgery and Health Sciences, University of Trieste, Italy and Clinical Medicine and Rheumatology Unit, Cattinara University Hospital, Trieste, Italy",
        "Centre for Inflammatory Diseases, Monash University, Melbourne, Victoria, Australia"
      ],
      "name": "Giacomo Emmi"
    }
  ],
  "title": "Epidemiology changes in systemic lupus erythematosus in Italy: the EASIEST study",
  "uid": "72dccb7f-5839-5108-8588-267e11f55bdf"
}