Disease development and outcome

Systemic lupus erythematosus (SLE) is a disease of variable course and prognosis. Clinical manifestations of SLE are reviewed, with an emphasis on the most common types of disease damage related to SLE itself and other factors. Tools to assess lupus outcomes, including disease activity, disease damage, and patient-reported outcomes, are increasingly used in clinical practice and clinical trials to improve care. Diagnostic and therapeutic advances have led to improved survival in SLE patients over the last 50 years, but lupus patients still have a higher mortality than the general population. Risk factors for mortality, including organ specific SLE manifestations, race/ethnicity, and socioeconomic status, are discussed. A growing body of treatment guidelines and quality indicators provide a clinical framework to mitigate disease activity and damage and improve patient outcomes.