International Journal of Rheumatic Diseases最新文献

{"title":"Glucagon-Like Peptide-1 Receptor Agonists: Multifaceted Roles in Immune and Inflammatory Regulation, Glycemic Control, and Synergistic Therapeutic Applications","authors":"Chia-Chien Hsu, Chi-Jen Hsu, Xiangpei Fang, Fu-Shun Yen, Pui-Ying Leong","doi":"10.1111/1756-185X.70199","DOIUrl":"https://doi.org/10.1111/1756-185X.70199","url":null,"abstract":"<p>Glucagon-like peptide-1 (GLP-1) has gained considerable attention in recent years for its crucial role in glycemic and weight control, as well as its potential impact on inflammation and immune function. Secreted by enteroendocrine cells in response to nutrient intake, GLP-1 stimulates insulin secretion, reduces glucagon release, and slows gastric emptying [<span>1</span>]. Beyond these effects, GLP-1 has multifaceted roles, including a complex interplay between inflammatory processes and immune regulation. The use of GLP-1 receptor agonists (GLP-1RAs) has been linked to significantly lower risks of all-cause mortality, cardiovascular events, and both cardiovascular and liver-related mortality [<span>2</span>]. Recent studies have further explored the anti-inflammatory properties of oGLP-1 drugs and their effect on the immune system, unveiling additional mechanisms of action.</p><p>Originally developed as a diabetes treatment due to its ability to stimulate insulin secretion from beta cells, GLP-1's effects extend beyond glucose regulation to include significant roles in immune cell function. One of its notable impacts is on macrophage polarization. Research indicates that GLP-1 can modulate macrophage activity, highlighting its potential in controlling chronic inflammation. Activation of the GLP-1 receptor has been shown to shift macrophages from the pro-inflammatory M1 phenotype to the anti-inflammatory M2 phenotype. This transition is associated with a reduction in inflammatory mediators and an enhancement of tissue repair mechanisms [<span>3</span>]. For instance, in a murine model of diet-induced non-alcoholic fatty liver disease (NAFLD), liraglutide demonstrated protective effects by promoting cAMP-PKA-STAT3-dependent polarization of Kupffer cells towards an M2 phenotype [<span>4</span>].</p><p>Moreover, GLP-1 receptor expression in T cells, particularly apoptotic and anergic cells, functions as a negative costimulatory molecule for T cells. This action has been shown to prolong allograft survival, mitigate alloimmunity, and even trigger antitumor immunity in a mouse model of colorectal cancer [<span>5</span>].</p><p>A recent study uncovered a novel mechanism by which GLP-1 receptor agonists (GLP-1RAs) increase intestinal <i>Escherichia coli</i> levels. This increase has been associated with sympathetic nervous system activation, resulting in the release of norepinephrine into the intestinal lumen. Elevated <i>E. coli</i> levels may contribute to bacterial translocation by downregulating the expression of intestinal tight junction genes under stress. However, the implications of this rise in <i>E. coli</i> levels require further investigation [<span>6</span>].</p><p>Activation of the GLP-1 receptor has also been shown to have significant anti-inflammatory effects. In a study by Chaudhuri et al., 24 obese individuals with type 2 diabetes mellitus (T2DM) were treated with the GLP-1 analog exenatide for 12 weeks. This treatment significantl","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185X.70199","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Mitral Valve Chordae Tendineae Rupture and Splenic Infarction in Granulomatosis With Polyangiitis","authors":"Irem Sahinoğlu, Sadettin Uslu, Ulkü Güc, Fatma Can, Mustafa Ucar, Ayca Tan, Ozgül Soysal Gündüz","doi":"10.1111/1756-185X.70214","DOIUrl":"https://doi.org/10.1111/1756-185X.70214","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NHIRD and TriNetX in Rheumatology: Opportunities and Challenges","authors":"Chao Chieh Cheng, Po-Cheng Shih, Su Boon Yong, Edward Chia-Cheng Lai","doi":"10.1111/1756-185X.70203","DOIUrl":"https://doi.org/10.1111/1756-185X.70203","url":null,"abstract":"<p>Rheumatic diseases are prevalent worldwide, with a considerable impact on patients' quality of life and a tendency to require long-term management. These conditions are complicated by common comorbidities, including cardiovascular disease, endocrine disorder, and mood disorder, further increasing both disease burden and treatment complexity. While biological therapies have revolutionized the management of various rheumatic diseases, high costs, potential adverse effects, and the heterogeneity of patient populations remain significant barriers to achieving optimal, personalized care.</p><p>In the history of the development of clinical research, randomized controlled trials (RCTs) have been the gold standard for evaluating efficacy and safety. However, their strict inclusion and exclusion criteria, limited sample sizes, and relatively short follow-up periods may fail to capture the full spectrum of disease heterogeneity and long-term real-world positive and negative outcomes. However, the use of real-world evidence (RWE) in research, as demonstrated in the original article published in the <i>International Journal of Rheumatic Diseases</i> in early 2019 (Su-Boon Yong et al., 2019) [<span>1</span>], has brought new hope for addressing such predicaments. Real-world evidence (RWE) derived from large-scale data sources, such as Taiwan's National Health Insurance Research Database (NHIRD) and the recent build global networks like TriNetX, offers the potential to overcome many of these limitations.</p><p>This editorial intends to explore the growing influence of RWE on rheumatologic research, discussing both its potential benefits and its limitations. We also highlight future directions for leveraging big data—particularly from Taiwan's NHIRD, TriNetX, and other global repositories, to optimize treatment strategies, refine risk prediction models, and guide real-world clinical decision-making in rheumatology.</p><p>The large heterogeneity of diseases leading to the challenge of research, such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and idiopathic inflammatory myositis (IIM), each exhibiting considerable variability in clinical manifestations, progression, and therapeutic responses. Diagnostic accuracy is often compromised by nonspecific presentations and the limited reliability of current biomarkers, incomplete imaging data sets, and then elevating the risk of misdiagnosis. These limitations are especially magnified in rare rheumatic diseases, where small patient populations restrict the feasibility of clinical trials and inflate the costs of multinational studies.</p><p>With the advances of biological and targeted synthetic medications emerging, prolonged follow-up studies are frequently hampered by high financial demands and significant patient attrition. Insufficient resources, particularly in the realm of rare diseases and innovative drug development, further restrict progress [<span>2</span>].</p><p>To overcome these chal","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185X.70203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Atherosclerosis in Pediatric Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis","authors":"Pratap Kumar Patra,&nbsp;Aaqib Zaffar Banday,&nbsp;Adil Asghar,&nbsp;Rashmi Ranjan Das,&nbsp;Pakkiresh Reddy,&nbsp;Priyanka Priyanka,&nbsp;Pallavi Singh,&nbsp;Nutan Sharma,&nbsp;Shagufta Naaz,&nbsp;Rahila Nisar,&nbsp;Dharmagat Bhattarai,&nbsp;Abdus Sami Bhat,&nbsp;Anju Gupta","doi":"10.1111/1756-185X.70217","DOIUrl":"https://doi.org/10.1111/1756-185X.70217","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Adults with systemic lupus erythematosus (SLE) are at a higher risk of cardiovascular complications. Numerous meta-analyses in adults with SLE have consistently demonstrated altered surrogate parameters of atherosclerosis (subclinical atherosclerosis). However, meta-analyses assessing the impact of pediatric SLE (pSLE) on cardiovascular health are lacking. Herein, we perform a systematic review and meta-analysis of studies assessing subclinical atherosclerosis in pSLE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Embase, Web of Science, and PubMed databases were systematically searched for pertinent literature published between January 1965 and February 2024. Patients with SLE and healthy participants were included as cases and controls, respectively. Online PICO portal, Newcastle–Ottawa scale, Review Manager and R software, and GRADEpro GDT tool were used for study deduplication and data extraction, study quality evaluation, data synthesis/analysis (including meta-regression), and certainty of evidence assessment, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 9 studies (out of 126 citations), including 1021 participants (528 cases and 493 controls), were included in the analysis. Carotid intima–media thickness (CIMT) and pulse wave velocity (PWV) were significantly higher in cases as compared to controls [mean difference (MD) 0.04 (95% CI 0.01–0.08) mm, <i>p</i> = 0.007 and MD 0.48 (95% CI 0.02–0.94) m/s, <i>p</i> = 0.04, respectively]. The flow-mediated dilatation was similar in the two groups. Significant heterogeneity was observed for all the outcome measures. On meta-regression analysis, disease duration correlated significantly with both CIMT MD and PWV MD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A “low”-quality evidence suggests that pSLE may adversely impact vascular microanatomy and physiology. Longitudinal studies are needed to precisely quantify the cardiovascular risk in pSLE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Registration</h3>\u0000 \u0000 <p>PROSPERO (CRD42022323752).</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal Renal Tubular Acidosis due to Sjogren's Syndrome Presenting as Quadriparesis in Pregnancy","authors":"Ilakyaa Rajakumar,&nbsp;Karthiga Prabhu Jayachandraprabhu,&nbsp;Vidhyalakshmi Ramadoss Kabilan,&nbsp;Udhaya Parivallal,&nbsp;Gerry George Mathew,&nbsp;Varadharajan Jayaprakash","doi":"10.1111/1756-185X.70208","DOIUrl":"https://doi.org/10.1111/1756-185X.70208","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Protective and Predisposing HLA-B Alleles and MICA Variants (MICA*049 and MICA*00901) in South Indian Behçet's Disease","authors":"Jiss John Francis,&nbsp;Spoorthi Raj D. R.,&nbsp;Ardra Das,&nbsp;Vivek Vinod,&nbsp;Mithun C B,&nbsp;Lalitha Biswas","doi":"10.1111/1756-185X.70221","DOIUrl":"https://doi.org/10.1111/1756-185X.70221","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoarthritis, What and What Not to Treat","authors":"Hyun Ah Kim","doi":"10.1111/1756-185X.70210","DOIUrl":"https://doi.org/10.1111/1756-185X.70210","url":null,"abstract":"&lt;p&gt;Osteoarthritis (OA) is the most common form of arthritis, and with the aging of the world population, its significance in terms of health expenditure and quality of life is increasing [&lt;span&gt;1&lt;/span&gt;]. Although cartilage destruction is a main pathology of OA, synovial inflammation, subchondral bone sclerosis, osteophyte formation, and changes in periarticular muscles also play important roles [&lt;span&gt;2&lt;/span&gt;]. Despite decades of intensive research, the treatment of OA has been unsatisfactory, and not a single disease-modifying OA drug (DMOAD) has been approved, creating a huge unmet need in modern medicine. With this dismal situation, we have to raise questions about whether our current understanding and approaches toward OA are appropriate.&lt;/p&gt;&lt;p&gt;To begin with, the fundamental question is what the distinction between disease and the natural process of aging is for OA. This is a question that has been raised for a long time. Although many researchers simply regard OA as a disease, the distinction is not always clear. The average life expectancy has risen from 47 to 73 years of age in the seven decades spanning 1950–2020 [&lt;span&gt;3&lt;/span&gt;]. This rate of increase in life expectancy is unprecedented, considering that the same amount of lifespan expansion occurred spanning thousands of years from the Bronze age to the beginning of the 20th century [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Among all the human organs affected by the detrimental effect of aging, human knee joints bear the brunt of yet another evolutionary burden, bipedal walking, which separates hominids from the rest of the four-legged mammals. Quadrupedal laboratory rodents rarely develop OA, even in obese animals; however, obligatory bipedal exercise leads to pathologic changes compatible with human OA cartilage degeneration [&lt;span&gt;5, 6&lt;/span&gt;]. This leads us to speculate that OA may be an evolutionary maladaptation; human knee joints may be poorly equipped to sustain such a massive increase in mechanical load occurring during such an abruptly prolonged life span.&lt;/p&gt;&lt;p&gt;Evolutionary maladaptation is reflected in the gap between lifespan, that is, the total life lived, and health span, that is, the period free from disease, which is currently estimated at around 9 years [&lt;span&gt;7&lt;/span&gt;]. OA may be a strong driver for increasing this gap considering the strong influence of age on its prevalence. The World Health Organization (WHO) guiding principle of achieving health as “a state of complete physical, mental and social well-being” is not possible through technological advances only [&lt;span&gt;7&lt;/span&gt;]. In that regard, OA treatment might better focus on how to protect natural joints for elongated life span by creation of favorable work condition and lifestyle factors.&lt;/p&gt;&lt;p&gt;The second question is whether we are aiming at the right target to alleviate patient suffering. The poor correlation between structural, especially cartilage, damage and patient symptoms is well known. Knee pain due to OA is a key symp","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185X.70210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computer Vision Techniques for Enhanced Detection of JIA Joint Inflammation","authors":"Meraj Alam Siddiqui,&nbsp;Burak Baskin,&nbsp;Esra Baskin","doi":"10.1111/1756-185X.70205","DOIUrl":"https://doi.org/10.1111/1756-185X.70205","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutralization of IL-17 and CXCR1 Protects Septic Arthritis by Regulating CXCL8-CXCR1 Pathway Along With Functional Activities in Neutrophils","authors":"Sharmistha Ghosh,&nbsp;Biswadev Bishayi","doi":"10.1111/1756-185X.70144","DOIUrl":"https://doi.org/10.1111/1756-185X.70144","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The main objective of this study is to elucidate the role of CXCR1 Ab, IL-17 Ab, and gentamicin in protecting septic arthritis by regulating neutrophil functional responses while evaluating the contribution of the CXCL8-CXCR1 pathway.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eighty-four experimental swiss albino mice were utilized to study septic arthritis. They were divided into eight groups. After developing sepsis, respective mice groups were treated with CXCR1 Ab, IL-17 Ab, and gentamicin doses. Doses were administered on days 1, 8, and 13 of the experimental schedule. At the early, middle, and late phases of the experiment i.e. at 3, 10, and 15 DPI (Days Post Infection), mice were sacrificed and blood and tissues were collected for further experimental evaluations. Different functional studies were performed on isolated blood neutrophils, spleen, and synovial tissues. Histological evaluation, immunofluorescence study, sepsis profile, and downstream signaling pathway analysis were done to obtain data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Infected mice group exhibited high inflammatory responses while treatment helped to mitigate them. IL-17 neutralization helped to lower bacterial burden, neutrophil ROS activity, MPO activity, and ALP activity. However, the combined neutralization of CXCR1 and IL-17 greatly influenced PMN chemotactic activity and lysozyme activity. At the early phase of the experiment, IL-17 neutralization's impact was more prominent, while later, CXCR1 neutralization gained the upper hand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We can conclude that IL-17 Ab in combination with gentamicin is potent in modulating neutrophil activities positively to cure sepsis, while CXCR1 Ab, through the CXCL8/CXCR1 pathway, regulates neutrophil functional activities by impacting different downstream signaling cascades.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Belimumab in Childhood Onset SLE: Update and Evidence","authors":"Tui Lin Yen,&nbsp;Su-Boon Yong,&nbsp;Chin-Yuan Yii,&nbsp;Chao-Yi Wu","doi":"10.1111/1756-185X.70207","DOIUrl":"https://doi.org/10.1111/1756-185X.70207","url":null,"abstract":"&lt;p&gt;Childhood onset systemic lupus erythema (cSLE) or pediatric onset SLE is a rare autoimmune disease among children and young adolescents, accounting for 10%–20% of all SLE patients. cSLE has a reported incidence rate of 0.3–0.9 per 100,000 children-years and a prevalence ranging from 3.3 to 8.8 per 100,000 children [&lt;span&gt;1&lt;/span&gt;]. The average age of presentation of cSLE is 11–12, and it rarely happens in children aged below 5 [&lt;span&gt;2&lt;/span&gt;]. Previous studies have concluded that cSLE is more common in females than males with a ratio of 4–5:1, but the sex ratio was lower compared to adult SLE, with a ratio of 9:1 [&lt;span&gt;1&lt;/span&gt;]. In contrast to adult SLE, cSLE patients usually have greater accrual of damage, higher disease activity, more frequent organ involvement, and worse outcomes compared to adult onset SLE [&lt;span&gt;3, 4&lt;/span&gt;]. Other studies have shown a higher risk of developing major depression in cSLE patients and juvenile SLE patients compared to adult onset SLE [&lt;span&gt;5&lt;/span&gt;], posing a great challenge for treatment and maintaining quality of life.&lt;/p&gt;&lt;p&gt;Before the recent breakthrough of biologic in SLE treatment, hydroxychloroquine, glucocorticoids, and immunosuppressants were the main treatment options for SLE [&lt;span&gt;6&lt;/span&gt;]. Despite standard regime's efficacy in disease control, it also compromised patient immunity, making infection one of the major causes of morbidity and mortality in the SLE population [&lt;span&gt;7&lt;/span&gt;]. Nonetheless, osteoporosis, cataracts, and coronary artery disease are significant side effects that should not be overlooked in long-term steroid users [ref]Above all these complications, children and adolescents before puberty are more likely to be exposed to prolonged high-dosed corticosteroid treatment and are more vulnerable. Long-term use of supraphysiological doses of corticosteroids, undernutrition, altered body composition with lean mass reduction, physical inactivity, delays in pubertal onset, or slow pubertal progression [&lt;span&gt;8&lt;/span&gt;]. The need for steroid-sparing agents to achieve better disease control is therefore urgent for this population.&lt;/p&gt;&lt;p&gt;Trial of belimumab in children with lupus was reported in 2020 by Brunner et al. [&lt;span&gt;9&lt;/span&gt;] suggesting that intravenous pharmacokinetics and benefit–risk profile in cSLE are consistent with adult belimumab studies.&lt;/p&gt;&lt;p&gt;To assess the efficacy and potential complications of belimumab in children, we aim to review the latest real-world evidence of its use in patients under the age of 18. We conducted a literature search on PubMed using keywords “Belimumab,” “SLE,” “systemic lupus erythematosus,” “lupus nephritis,” “lupus,” “childhood onset,” “childhood,” “pediatric,” “juvenile,” “children,” and filtered literature published in the last 5 years; the search term is as follows:&lt;/p&gt;&lt;p&gt;&lt;i&gt;(Belimumab[Title/Abstract]) AND ((((SLE[Title/Abstract]) OR (systemic lupus erythematosus[Title/Abstract])) OR (lupus nephritis[Title/Abstract])) OR (lupus[Title/Ab","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 4","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185X.70207","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}