Lupus & antiphospholipid syndrome
Impact of rural residence on clinical outcomes in SLE: a systematic review
Authors' conclusion
Across diverse settings, rural SLE populations frequently experience worse outcomes, although this is not universal and appears to be strongly influenced by structural disadvantages rather than geography alone.
Study context
- Population
- Adults with SLE in observational studies from the USA, Greece, China, Egypt, Puerto Rico and Latin America (GLADEL cohort)
- Participants
- over 34,000 adults8 studies
- Comparison
- Rural vs non-rural residence
- Outcome
- Clinical outcomes stratified by rurality
Methodological detailsnarrative synthesis, Newcastle-Ottawa Scale risk of bias, Methodological quality generally moderate to high
- Narrative synthesis
- Newcastle-Ottawa Scale risk of bias
- Methodological quality generally moderate to high
Pooled result
As reported in the abstract
Clinical outcomes in rural residence
- Rural residence often associated with delayed diagnosis, higher disease activity, lower physical quality of life, increased hospital readmissions and poorer medication adherence
- Survival findings mixed; one study found no rural disadvantage where specialised care was available
Original publication
Impact of rural residence on clinical outcomes in SLE: a systematic review. Lupus Sci Med. Published 7 October 2025. doi:10.
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