Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organs and is clinically and serologically heterogeneous. Worldwide its reported incidence stands at from 1 to 31.9/100,000 per year, at it is more common in mixed race populations.1

In spite of the advances made in diagnosis and treatment, its corresponding rates of morbimortality are still high. It mainly affects developing countries such as those in Latin America (LA), due to their socioeconomic and genetic characteristics, as these play a major role in the disease and lead to unfavourable outcomes.2

Given the problematic nature of SLE, it is important not only to analyse the trends in scientific production, but also to examine international collaboration with other countries. This is particularly so for this disease, as it requires a multidisciplinary approach as well as access to more specialised technology, with the participation of experienced authors in this field. The benefits of this will arise in terms of citation and impact, as well as better control of the disease.3

Bibliometric study identifies publishing tendencies in common fields of research, allowing researchers to improve the alignment of their investigative consultations to areas where evidence is lacking and to recognise the scientific production of each country and the collaboration it involves. However, there may be little research into this disease in LA, as Brazil and México are the only countries in the region which frequently produce material on this health problem.4

Due to the above considerations and given the incidence and resulting outcomes of the disease in LA populations, it would be relevant to analyse the trends in scientific production on this subject, using bibliometric analysis and studying collaboration.

Documents published in journals indexed in Scopus from 1982 to 2018 were analysed bibliometrically. Given the history and start of diagnostic criteria in 1982, this year was considered to be the key point to commence searching the literature on SLE.5

Our final search resulted in 3843 documents from 1982 to 2018 (Appendix A, additional material 2) about SLE in LA. An increasing tendency was found, with higher production in the year 2018 (267 documents). The annual average amounted to 35.4 documents per year, with an annual growth rate of 11%. In the last 20 years there was a significant increase in average scientific production in comparison with 1982–1998 (168.7 vs 35.4; P<.005). The greatest number of publications were original papers (n=2899; 75.4%) and review papers (n=523; 13.6%), while the smallest number produced corresponded to letters (n=206; 5.3%) and other types of document (n=215; 5.5%) (Fig. 1).

Fig. 1.

Overall scientific production tendency in Latin American countries with publications on systemic lupus erythematosus, 1982–2018. * Others: documents from congresses, notes, editorials, short surveys and errata.

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In the last 37 years 40 countries with at least 10 published documents were registered in Scopus, where 11 Latin American countries were recorded as having collaborated with 29 countries outside the region. The countries with the highest production (shown as percentages) and scientific collaboration (with more than 35 countries) were: Brazil (43.1%), México (29.4%), Argentina (10.8%), Colombia (9.8%) and Chile (4.1%), in collaboration mainly with the United States, Spain, the United Kingdom and France; while the countries with the least scientific collaboration (with fewer than 12 countries) were: Cuba (1.2%) and Uruguay (0.7%) (Fig. 2).

Fig. 2.

Latin American countries that had collaborated with foreign countries in the publication of papers on systemic lupus erythematosus. Analysis was weighted according to the number of documents, and 40 countries were included.

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At LA level, research into SLE in the last 5 years has increased considerably in comparison with previous years.4 This is associated with the complexity of the disease and the opening up of new fields of knowledge, such as translational or epigenetic research.8

Brazil and México were the countries where production and scientific collaboration were highest. This result is probably not a coincidence and may be explained in different ways. Firstly, both countries have the highest amount of scientific production in different fields within LA, principally in Medicine9 and Public Health.10 Secondly, both countries have their own SLE guidelines, prepared by the academic – scientific institutions such as the Brazilian Society of Rheumatology11 and the Mexican College of Rheumatology.12 Thirdly, SLE is a major problem in Brazil, where mortality trends have not improved consistently; this may be one of the reasons that would drive the need for research in this field. Fourthly, in the case of México, ethnic differences are known to be important in the pathogenesis and complications associated with SLE, and México is a multiethnic country,13 which would also be a reason for the special interest in researching this subject. Fifthly, it is probable that there is a connection with the sociodemographic data of these countries, as both of them have the highest total populations, the highest GDP and the highest percentage of GDP devoted to research and development in LA.14

On the other hand, it has to be said that the publication of original papers largely contributes to the generation of new knowledge,3 so that their publication in high impact journals would make them more visible and increase the number of citations (CiteScore & Scimago Journal Ranking). Likewise, obtaining financial support and scientific collaboration make it possible to share resources, skills and experience in interventions, achieving better results than would have been the case working individually. This could explain the good scientific performance of Brazil, México and Argentina in comparison with other LA countries,15 and their collaboration, mainly with the United States and Spain, both of which have specialised rheumatic disease centres and a good number of scientific publications about SLE.4

Some limitations should be mentioned. First, we do not include studies indexed in databases other than Scopus, which may lead to an underestimate of the actual total number of publications. Nevertheless, the Scopus database has greater advantages in terms of precision, citations and summaries of peer-reviewed literature in comparison with other databases.6 Second, there may be studies by Latin American authors that have not included their filiation in a LA institution, so that probably they have not been included in this analysis.

This paper offers interesting information on the scientific production on SLE in LA, and it finds a growing tendency. Brazil and México generated more than half of the publications in question, and they are the main sources of collaboration with Argentina. However, it is necessary to strengthen the collaborative capacity of other LA countries.

The authors have no conflict of interests to declare.