Systemic lupus erythematosus (SLE or lupus) is a life-threatening disease. It’s considered an autoimmune condition, which means the immune system mistakenly attacks the body’s own healthy tissues. Lupus complications can lead to early death in about 10 percent to 15 percent of people with the condition. However, recent advances in the diagnosis and treatment mean that most people with lupus can expect to live a long and healthy life.

Lupus affects everyone differently, so it can be hard to predict how lupus will affect you. In this article, we’ll discuss how different factors can affect your life expectancy (how long you’re predicted to live) and prognosis (expected outcome) with lupus.

1. Treatment Advances Have Greatly Improved Lupus Survival Rates

The survival rate refers to the percentage of people still alive after a certain amount of time after being diagnosed with lupus. For people diagnosed with lupus in the 1950s, the five-year survival rate was about 50 percent. That means only about half of the people diagnosed with lupus lived longer than five years.

In recent years, lupus research and new treatment options have greatly improved the lupus survival rate. Since the 1990s, the five-year survival rate for lupus has been over 90 percent. Between 85 percent and 90 percent of people live more than 10 years after their diagnosis, and 75 percent of people live at least 20 years. Similar survival rates have been reported in countries around the world.

2. Men With Lupus May Have Worse Outcomes

The Lupus Foundation of America reports that about 90 percent of people living with lupus are women. However, an article in the journal Rheumatology cites that lupus is often more severe in men, leading to worse outcomes and reduced life expectancy compared to women with lupus.

In a 2023 study comparing outcomes for men and women with lupus, researchers found that the five-year survival rate was 95 percent for women and 83 percent for men. Additionally, men in this study were more likely to have serious heart problems and kidney failure compared to women.

Researchers don’t understand why lupus can be more severe in men compared to women. However, men may find it more difficult to get a lupus diagnosis because of the assumption that this condition primarily affects women. This can lead to delays in diagnosis, which are also associated with worse outcomes in lupus. According to Trends in Urology & Men’s Health, being male is linked to a higher risk of worse outcomes.

3. Age at Diagnosis Can Affect Your Prognosis

Lupus symptoms typically develop between the ages of 15 and 44. However, children and older adults can also develop lupus.

Juvenile-Onset Lupus

When lupus develops in children, it’s called juvenile-onset or pediatric lupus. Juvenile-onset lupus is often more severe and comes with a higher risk of organ damage. This can lead to more serious complications over time, including frequent flare-ups, kidney disease, and early-onset heart disease.

Children with lupus are also more likely to need corticosteroids (steroids) to manage their symptoms throughout their lives. Although steroids are effective, they can cause more serious long-term side effects. These challenges contribute to a higher mortality (increased risk of death) in people diagnosed with juvenile-onset lupus compared to those diagnosed as adults.

Late-Onset Lupus

Between 3 percent and 18 percent of people are diagnosed with lupus after age 50, known as late-onset lupus. People diagnosed with lupus at an older age tend to have less severe symptoms but also have a lower survival rate compared to those diagnosed at a younger age.

Comorbidities are other health conditions that a person has in addition to their main illness. Compared to younger people, older adults tend to have more comorbidities, such as hypertension (high blood pressure), diabetes, and osteoarthritis. These comorbidities can complicate treatment, contributing to higher mortality in people with late-onset lupus.

4. Lupus Symptoms Are Often More Severe Among Certain Racial or Ethnic Groups

According to the Lupus Foundation of America, lupus is about two to three times more common in people of the following races/ethnicities:

• African American
• Hispanic
• Asian American
• Native American
• Alaska Native
• Native Hawaiian
• Pacific Islander

In addition to being a risk factor for developing lupus, people who belong to the groups outlined above also have an increased risk of more severe disease. African American, Hispanic, and Asian people with lupus tend to have more active disease and organ damage compared to white people.

A 2014 study from the journal Arthritis & Rheumatology found that Black women are more likely to develop lupus at a younger age and progress to more severe kidney disease compared to white women. Differences in genetic risk factors and social support in these groups may lead to poor outcomes.

5. Heart Disease Is a Leading Cause of Death in People With SLE

Cardiovascular disease (heart and blood vessel disease) is the leading cause of death for the general population in the United States, so it’s not surprising that it’s also one of the leading causes of death for people with lupus. However, those with lupus have a higher risk of developing heart disease compared to the general population. Researchers estimate people with lupus have a two to 10 times higher risk of heart disease.

Chronic (long-term) inflammation related to lupus can speed up atherosclerosis. In atherosclerosis, plaque (a sticky substance made of cholesterol and fat) builds up on blood vessels, restricting blood flow. If atherosclerosis restricts blood flow to the heart, it can cause a heart attack.

People with lupus are about 2.5 times more likely to develop atherosclerosis compared to those without lupus. Immunosuppressive drugs are medications that weaken the immune system’s activity. These treatments can help reduce the buildup of plaque in the arteries, which may lower the risk of heart disease.

6. Lupus Nephritis Can Affect Life Expectancy

Lupus nephritis happens when the immune system attacks the kidneys. About 60 percent of people with lupus develop lupus nephritis. In people who develop lupus nephritis, it usually occurs in the first five years after the first symptoms of lupus appear. Over time, kidney damage from lupus can cause kidney failure, which can be life-threatening without proper treatment.

People with lupus nephritis have a higher risk of death than the general population — about five to eight times higher, according to research. However, immunosuppressant drugs have helped many people with lupus nephritis live long lives. About 94 percent of people with lupus nephritis live at least five years after diagnosis, and 71 percent live at least 20 years.

7. Lupus Increases the Risk of Life-Threatening Infections

People with lupus have a higher risk of developing infections, which can affect life expectancy. Infections can be serious for people with lupus. In fact, about 1 in 3 lupus-related deaths are linked to severe infections.

Lupus makes people more prone to infection because the disease can weaken the immune system, making it more difficult to fight off infection-causing germs. Additionally, immunosuppressive treatments that help reduce harmful lupus-related inflammation also limit the immune system’s ability to prevent infection. People with lupus often need to take steroids for a long time to help control their symptoms. Among all the medications used in the treatment of lupus, steroid use increases the risk of infection by far. Respiratory (lung), skin, and urinary tract infections are the most common types of infections in people with lupus.

8. You Can Take Steps To Improve Your Life Expectancy

Treatment advances mean that most people with lupus have a much better outlook today than they did in the past. With proper treatment and healthy lifestyle habits, you can live a long and healthy life with lupus.

One of the most important ways to protect your health is to stay on top of your care with frequent follow-ups with your healthcare team. Work closely with your rheumatologist to help you manage your symptoms and check for complications. Even if you have mild lupus or think your lupus is under control, it’s important to check in with your healthcare team. You may be able to help prevent flare-ups and complications by taking your medication exactly as prescribed, even if you feel well.

Healthy lifestyle changes can help you feel better and prevent complications like heart disease. Examples of healthy lifestyle habits for lupus include:

• Eat a well-balanced diet with plenty of fruits, vegetables, and whole grains.
• Limit how much sodium (salt), saturated fat, and sugar you eat. Saturated fat is found in butter, cheese, red meat, and fried foods.
• Get regular exercise.
• Limit or avoid alcohol.
• Quit smoking.
• Focus on quality sleep.

With today’s treatments and regular medical care, many people with lupus are living longer, healthier lives. Knowing what can affect life expectancy — like your age at diagnosis, symptoms, and other health conditions — can help you and your doctor make informed choices. Sticking to your treatment plan and making healthy lifestyle changes may also help lower the risk of serious problems and improve your overall outlook.

Talk With Others Who Understand

On MyLupusTeam, the online social network for people with lupus and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Have you discussed factors that could affect your life expectancy with your healthcare team? Share your experience in the comments below, or start a conversation by posting on your Activities page.