Lupus最新文献

{"title":"Childhood systemic lupus erythematosus with lupus myositis: A report of 6 cases.","authors":"Gu Yuxuan, Chen Xin, Chen Zhiguo, Huang Yuchan, Wang Xinlei, Miao Jialei, Liu Ling, Li Chunzhen","doi":"10.1177/09612033261445771","DOIUrl":"10.1177/09612033261445771","url":null,"abstract":"<p><p>ObjectiveTo investigate the clinical characteristics of pediatric systemic lupus erythematosus complicated by myositis.MethodsA retrospective analysis was conducted on the clinical data of six patients with SLE-associated myositis, examining manifestations of multisystem involvement, muscle injury markers, and autoantibody profiles.ResultsAmong the six patients, five were female and one male, with a median age of 12 years. All patients presented with myalgia and/or muscle weakness. Physical examination revealed muscle weakness (grade 2-4) in all six children, with bilateral lower limb myalgia in 4. Laboratory findings showed elevated creatine phosphokinase levels ranging from 217 to 3317 U·L^-1 in four patients. All patients also exhibited elevated lactate dehydrogenase levels, ranging from 293 to 949 U/L. After treatment, clinical symptoms resolved in all patients, with the majority achieving stable conditions. Only one case experienced recurrence due to inappropriate drug tapering, which resolved following readmission and intensive treatment.ConclusionMyositis is not a common feature of SLE. Patients with SLE complicated by myositis should complete relevant investigations at the earliest opportunity. Early diagnosis and stratified individualized treatment can effectively control the disease.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"876-882"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839668","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":"Lower-dose glucocorticoid therapy achieves comparable outcomes in Japanese patients with lupus nephritis.","authors":"Yoshiyuki Abe, Ayako Makiyama, Kentaro Minowa, Saki Uchiyama, Masahiro Kogami, Motoki Takeuchi, Yoshiya Tanaka, Keiju Hiromura, Hiroki Hayashi, Kazuro Kamada, Yutaka Kawahito, Akiho Iwashita, Shinya Kaname, Hayato Shimizu, Shinsuke Yasuda, Kazuoto Hiramoto, Shoichi Maruyama, Nobuyuki Yajima, Yasunori Iwata, Isao Matsumoto, Takahisa Gono, Hiroko Sato, Satoshi Kubo, Hidekazu Ikeuchi, Yukio Yuzawa, Michihito Kono, Takahiro Seno, Akira Onishi, Takahisa Kawakami, Tadashi Hosoya, Yuko Kaneko, Sawako Kato, Shiori Nakagawa, Yuya Kondo, Masataka Kuwana, Tomonori Ishii, Tatsuya Atsumi, Koichiro Ohmura, Naoto Tamura","doi":"10.1177/09612033261449985","DOIUrl":"10.1177/09612033261449985","url":null,"abstract":"<p><p>ObjectiveTo evaluate the effectiveness of a lower initial glucocorticoid (GC) dose (0.4-0.6 mg/kg/day) compared to the conventional dose (0.8-1.2 mg/kg/day) in achieving complete renal response (CRR) at 12 months in Japanese patients with proliferative lupus nephritis (LN).MethodsThis multicentre, retrospective observational study analyzed data from 344 Japanese patients diagnosed with LN (class III or IV ± V) via renal biopsy. Patients were divided into two groups based on their initial dose of GC. 1:1 propensity score matching (PSM) based on key baseline variables, 23 patients were included in each group. The primary endpoint was CRR at 12 months, defined according to the BLISS-LN trial criteria. A non-inferiority margin of -10% was prespecified.ResultsAfter PSM, the CRR rate at 12 months was 87.0% in the low-dose group and 73.9% in the conventional-dose group (risk difference: 13.1%; 95% confidence interval [CI]: -9.4% to 35.6%), confirming statistical non-inferiority. While GC doses differed significantly during the initial 3 months, they became comparable between the groups after 6 months.ConclusionA reduced initial GC dose of 0.4-0.6 mg/kg/day achieved renal outcomes comparable to conventional dosing in Japanese patients with LN. Given the risks of GC toxicity, these findings may support the potential for lower-dose GC strategies in LN treatment.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"831-841"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839648","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":"Long-term outcomes of patients with moderate-severe pediatric systemic lupus erythematosus treated with combination rituximab and cyclophosphamide therapy: A single center cohort experience and review of literature.","authors":"Aneesha Achar, Peyton Houser, Julie Cherian, Farzana Nuruzzaman","doi":"10.1177/09612033261441392","DOIUrl":"10.1177/09612033261441392","url":null,"abstract":"<p><p>ObjectiveTo determine the long-term outcomes of patients with moderate-severe pediatric systemic lupus erythematosus (pSLE) treated with systematic administration of combination rituximab (RTX) and cyclophosphamide (CYC) at our institution.MethodsPatients with moderate-severe pSLE treated with the combination RTX/CYC therapy between 2013 and 2023 at a single center were included. Steroid exposure, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores, and Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) damage indices were collected as primary outcomes. We also reviewed the literature of the use of RTX/CYC therapy in pSLE.ResultsEleven patients received RTX/CYC therapy in our cohort. Six of 11 patients (55%) were Black. All patients achieved sustained low disease activity as defined by SLEDAI score less than 4 and prednisone dose less than 8 mg/day. There was no statistically significant change in the SLICC/ACR damage index over time. Positive clinical outcomes were observed in all racial groups. Two of 11 patients (18%) required hemodialysis, with one requiring a transplant. Other adverse effects included anaphylaxis and cytopenias. Several reports of use of RTX/CYC therapy were identified in our literature search. Our cohort had a more racially diverse cohort compared to other studies identified in our literature review.ConclusionsOur study supports the use of rituximab and cyclophosphamide use in patients with pSLE and demonstrates its efficacy among a racially diverse cohort over the long-term follow-up period. Our study has important limitations, and larger, prospective randomized clinical trials would allow for improved protocol evaluation and comparison.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"842-850"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633908","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":"Development and evaluation of frailty index for patients with systemic lupus erythematosus in China.","authors":"Meng-Yao Zhang, Mei-Qin Nie, Qian Tang, Xing-Yue Dai, Zhao-Liang Wang, Wen-Chen He, Guo-Cui Wu","doi":"10.1177/09612033261438992","DOIUrl":"10.1177/09612033261438992","url":null,"abstract":"<p><p>ObjectiveTo develop and validate a frailty assessment scale tailored for patients with systemic lupus erythematosus (SLE).MethodsBased on the theory of the frailty integration model, an initial draft of the frailty index questionnaire was developed through a comprehensive literature review and a two - round Delphi expert consultation. The final version of the scale was formed through a pre - survey and a formal survey. The validity of the questionnaire was tested using content validity, structural validity, and criterion - related validity. The reliability was evaluated using Cronbach's <i>α</i> coefficient, split - half reliability, and test - retest reliability.ResultsThe initial item pool of the scale contained 3 dimensions and 32 items. After two rounds of Delphi expert consultations, the draft scale was refined to 21 items across 3 dimensions. Pilot testing with 50 SLE patients further reduced it to 14 items. The formal content validity Cronbach's <i>α</i> coefficient was 0.809, the split - half reliability was 0.745, the KMO was 0.820, and the Bartlett's test value was 2915.855 (<i>p</i> < 0.001). The results of exploratory factor analysis showed that, except for a few items, the correlation coefficient between the score of each item and its score in the corresponding dimension was greater than 0.4, and the overall correlation coefficient was 0.832 (<i>p</i> < 0.001). The optimal cutoff value for the pre - frailty stage was 28.5, and that for the frailty stage was 40.5.ConclusionThe frailty index scale developed in this study is a valid and reliable tool for assessing frailty in SLE patients in China, with potential utility in clinical and research settings.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"779-788"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618992","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":"Primary headaches in juvenile-onset systemic lupus erythematosus: A preliminary case control study using ICHD-3 criteria.","authors":"Bengisu Menentoğlu, Gülşah Kavrul Kayaalp, Selen Duygu Arık, Aslı Dudaklı, Cenk Baykan, Özlem Akgün, Hülya Maraş Genç, Fatma Gül Demirkan, Figen Çakmak, Edibe Pembegül Yıldız, Nuray Aktay Ayaz","doi":"10.1177/09612033261445761","DOIUrl":"10.1177/09612033261445761","url":null,"abstract":"<p><p>IntroductionHeadache is one of the most frequent neurological symptoms in SLE; however, its definition and relationship with the disease remain unclear. Distinguishing whether a headache is attributable to lupus or represents a primary headache disorder can be challenging. This preliminary study aimed to investigate the prevalence, frequency, and associated clinical factors of primary headaches in juvenile-onset SLE (jSLE) compared to healthy peers.MethodsThis cross-sectional case-control study included 32 children with jSLE and 38 age- and sex-matched healthy controls, who were evaluated between July and September 2025. Headache characteristics were assessed using a standardized questionnaire and classified according to the International Classification of Headache Disorders, 3rd edition (ICHD-3). All participants underwent neurological and fundoscopic examinations. Clinical, laboratory, and treatment-related parameters including disease activity (SLEDAI-2K), cumulative dose of systemic corticosteroids, and autoantibody profiles were compared between jSLE patients with and without primary headache.ResultsPrimary headache was observed in 31.3% of jSLE patients (10/32) and 10.5% of controls (4/38) (<i>p</i> = 0.03). Among jSLE patients with headache, migraine without aura (60%) and tension-type headache (40%) were the predominant subtypes. Compared with those without headache, patients with headache had higher BMI z-scores (<i>p</i> = 0.03), shorter sleep duration (<i>p</i> = 0.03), more frequent antiphospholipid antibody positivity (<i>p</i> = 0.04), and higher cumulative corticosteroid doses (<i>p</i> = 0.02). Disease activity and duration did not differ significantly.ConclusionPrimary headaches, particularly migraine, are more frequent in pediatric lupus compared to healthy controls. Their associations with BMI, sleep, antiphospholipid antibodies, and corticosteroid exposure suggest multifactorial origins rather than direct links to disease activity. These findings highlight the need for larger, prospective studies to clarify underlying mechanisms.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"851-858"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13230663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729209","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":"Clinical outcomes of anifrolumab after belimumab failure in systemic lupus erythematosus: A single-center case series.","authors":"Shunichiro Hanai, Yoshiaki Kobayashi, Mayu Yazaki, Nakako Tanaka-Mabuchi, Kojiro Ikeda, Soichiro Kubota, Daiki Nakagomi","doi":"10.1177/09612033261442824","DOIUrl":"10.1177/09612033261442824","url":null,"abstract":"<p><p>ObjectivesTo describe clinical outcomes after switching to anifrolumab in patients with systemic lupus erythematosus (SLE) who showed inadequate response to belimumab, and to explore clinical features potentially associated with treatment response in real-world settings.MethodsWe retrospectively reviewed the cases of eight patients with SLE who were switched from belimumab to anifrolumab because of insufficient clinical response. Clinical data, including the SLE Disease Activity Index 2000 (SLEDAI-2K), serological markers, organ involvement, medication use, and attainment of a lupus low disease activity state (LLDAS), were descriptively evaluated.ResultsAll eight patients were female; most were young and had active mucocutaneous manifestations. Three patients presented with cutaneous vasculitis and one with panniculitis. Three patients had neuropsychiatric manifestations, including mood disorders or cerebrovascular disease, and one patient had membranous lupus nephritis. Following anifrolumab initiation, clinical improvement was observed predominantly in skin and neuropsychiatric manifestations, whereas renal involvement showed limited improvement. Improvements in SLEDAI-2K scores, complement levels, and glucocorticoid dose reduction were observed in most patients. Five patients achieved LLDAS during follow-up. Clinical improvement was more frequently observed among younger patients and those with active skin manifestations and anti-ribonucleoprotein antibody positivity.ConclusionsIn this exploratory case series, switching from belimumab to anifrolumab was associated with clinical improvement among selected patients with SLE. Certain clinical features, including active skin or neuropsychiatric manifestations and anti-ribonucleoprotein antibody positivity, were more frequently observed among patients who showed improvement after switching therapy. These findings should be interpreted as hypothesis-generating and warrant confirmation in larger prospective studies.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"869-875"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674709","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":"Prognostic risk score for end-stage kidney disease in Latin American lupus nephritis: Integrating clinical and histological data.","authors":"Luis Alonso González, Mauricio Restrepo-Escobar, Alejandra Taborda, Lina Aguirre, Joaquín Rodelo-Ceballos","doi":"10.1177/09612033261441398","DOIUrl":"10.1177/09612033261441398","url":null,"abstract":"<p><p>ObjectivesTo develop a clinically applicable risk prediction score for end-stage kidney disease (ESKD) in Latin American patients with lupus nephritis (LN), using clinical and histopathological data obtained at the time of kidney biopsy.MethodsWe conducted a retrospective cohort study of 433 adults (≥18 years) with biopsy-proven LN at Hospital San Vicente Fundación (Medellín, Colombia) between January 2011 and May 2025. ESKD was defined as eGFR <15 mL/min/1.73 m² for ≥3 months, dialysis >3 months, or kidney transplantation. Predictors of ESKD were identified using univariable and multivariable Cox regression and incorporated into a weighted risk score, stratifying patients into low (≤2 points), moderate (3-6), and high (7-10) risk categories.ResultsEighty-eight patients (20.3%) progressed to ESKD at a median of 3 months post-biopsy. Multivariable analysis identified hypertension (HR 1.73), baseline eGFR <60 mL/min/1.73 m² (HR 4.40), proliferative LN (HR 4.03), mNIH activity index ≥7 (HR 1.56), and chronicity index ≥3 (HR 2.24) as independent predictors of ESKD. The resulting risk score stratified patients into low (<i>n</i> = 80), moderate (<i>n</i> = 215), and high-risk (n = 138) groups, with ESKD incidences of 0%, 11.6%, and 45.7%, respectively (<i>p</i> < 0.001). The model demonstrated good discriminatory performance, with a Harrell's C-index of 0.83.ConclusionsWe developed a simple yet robust risk score for predicting ESKD in Latin American patients with LN, integrating key clinical and histopathological factors. This tool effectively stratifies patients by risk and may support in guiding treatment decisions in clinical practice.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"789-799"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633955","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":"Association between interstitial fibrosis/tubular atrophy (IFTA) on kidney biopsies and anti Ro60 antibody positivity in patients with lupus nephritis (LN).","authors":"Homa Timlin, Abbal Koirala, Avi Rosenberg, Oluwadamilola Adisa, Mohamed G Atta, Ihab Kamel, Matthew Gross, Alana Dasgupta, Duvuru Geetha","doi":"10.1177/09612033261443602","DOIUrl":"10.1177/09612033261443602","url":null,"abstract":"&lt;p&gt;&lt;p&gt;BackgroundInterstitial fibrosis and tubular atrophy (IFTA) are key predictors of renal outcomes in lupus nephritis (LN), but serologic markers that identify patients at higher risk for tubulointerstitial damage are poorly defined. Anti-Ro60 antibodies are associated with heightened systemic immune activation and worse renal outcomes in systemic lupus erythematosus, but their relationship to IFTA in LN is unknown.MethodsWe performed a retrospective cohort study of adults with biopsy-confirmed LN at a single academic center. Clinical data, autoantibody profiles, and renal histopathology were abstracted from the medical record at or near the time of kidney biopsy. Ro60 status was determined by standard clinical immunoassays. IFTA severity was graded by a renal pathologist as none, mild, moderate, or severe. Ordinal logistic regression was used to evaluate the association between Ro60 positivity and IFTA severity. A multivariable proportional odds model included Ro60 positivity (primary exposure), Black race (the only variable with &lt;i&gt;p&lt;/i&gt; &lt; 0.05 in the univariable analysis), and ISN/RPS class IV LN (an a priori clinical risk factor for fibrosis). Sensitivity analyses included dichotomizing IFTA (absent/mild vs moderate/severe), excluding the single severe IFTA case, and restricting to Black patients.ResultsForty-one patients met the inclusion criteria; 16 (39%) were Ro60-positive, and 25 (61%) were Ro60-negative. Ro60-positive patients were more often Black and had lower C3 and C4 levels; the distribution of LN classes was similar between groups. In univariable analysis, Ro60 positivity was associated with higher odds of more severe IFTA (OR 3.05; 95% CI 0.86-11.5; &lt;i&gt;p&lt;/i&gt; = 0.087), while Black race was strongly associated with worse IFTA (OR 7.82; 95% CI 1.02-93.12; &lt;i&gt;p&lt;/i&gt; = 0.014). In the multivariable model limited to 29 complete cases, Ro60 positivity remained associated with higher IFTA severity (OR 2.76; 95% CI 0.77-13.04; &lt;i&gt;p&lt;/i&gt; = 0.127), and Black race remained the strongest predictor (OR 8.06; 95% CI 0.92-275.61; &lt;i&gt;p&lt;/i&gt; = 0.015); class IV LN was not significantly associated with IFTA (OR 1.90; 95% CI 0.37-13.24; &lt;i&gt;p&lt;/i&gt; = 0.371). In a sensitivity analysis excluding the single patient with severe IFTA, the association between Ro60 positivity and IFTA strengthened (OR 5.25; &lt;i&gt;p&lt;/i&gt; = 0.028), and Black race remained strongly associated with worse IFTA (OR 15.79; &lt;i&gt;p&lt;/i&gt; = 0.005).ConclusionsIn this biopsy-based LN cohort, Ro60 positivity was associated with a consistent trend toward more severe IFTA, with a statistically significant association in sensitivity analysis excluding one severe outlier case. Black race was the most robust predictor of IFTA severity, highlighting persistent racial disparities in LN-related kidney damage. These findings support the hypothesis that anti-Ro60 antibodies contribute to tubulointerstitial injury and suggest that Ro60 status may help identify LN patients at higher risk for chronic structural","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"810-817"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699357","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":"Treatment patterns and outcomes of first lupus nephritis episode over 25 years in two Latin American cohorts.","authors":"Rosana Quintana, Lucia Hernández, Guillermo Pons-Estel, Marina Scolnik, Gisela Subils, Otaduy Cintia, Verónica Saurit, Valeria Arturi, Guillermo A Berbotto, Luciana Gonzalez Lucero, Eduardo Mario Kerzberg, Nicolás Perez, Cecilia Nora Pisoni, Maria Elena Crespo, Joaquín Martinez Serventi, Ana Carolina O S Montandon, Odirlei Andre Monticielo, Henrique Ataide Mariz, Evandro Mendes Klumb, Eduardo F Borba, Luciana Parente Costa Seguro, Edgard Torres Dos Reis-Neto, Eloisa Bonfa, Alexis Bondi Peralta, Milena Mimica, Gustavo Aroca Martínez, Andrés Cadena Bonfanti, Carlos A Cañas, Gerardo Quintana-Lopez, Carlos Enrique Toro Gutiérrez, Mario Javier Moreno Alvarez, Miguel Ángel Saavedra, Margarita Portela Hernández, Hilda Fragoso-Loyo, Luis H Silveira, Ignacio García-Valladares, Carlos Abud-Mendoza, Jorge A Esquivel Valerio, Patricia Langjahr, Astrid Paats, Claudia S Mora-Trujillo, Manuel F Ugarte-Gil, Armando Calvo Quiroz, Roberto Muñoz Louis, Martín Rebella, Álvaro Danza, Ashley Orillion, Chetan Karyekar, Federico Zazzetti, Graciela S Alarcón, Bernardo A Pons-Estel","doi":"10.1177/09612033261445765","DOIUrl":"10.1177/09612033261445765","url":null,"abstract":"<p><p>ObjectivesTo compare the treatments used for the first episode of lupus nephritis (LN) in two Latin American cohorts (historical and contemporary) over a 25-year period, and their associations with clinical outcomes.MethodsPatients with biopsy-confirmed first LN episode were classified as non-proliferative (class V) or proliferative (classes III/IV). Sociodemographic, clinical, and treatment variables were described. Propensity score matching was used to examine the associations with four outcomes: mortality, damage accrual (SDI), hospitalization, and end-stage renal disease (ESRD).ResultsA total of 532 SLE patients were included: 362 from GLADEL 1.0 (historical cohort) and 170 from GLADEL 2.0. (contemporary). Compared to GLADEL 1.0, patients in GLADEL 2.0 received lower doses of oral glucocorticoids (GC), more frequently GC pulses and antimalarials but less frequently cyclophosphamide. An increase in the use of mycophenolate mofetil and other immunosuppressants was also observed. In the logistic regression models, SDI was associated with baseline SDI and GC pulses, whereas belonging to the GLADEL 2.0 was a protective factor. Mortality was associated with Mestizo ethnicity and partial health coverage; antimalarial was identified as a protective factor. Hospitalizations were associated with baseline SLEDAI and SDI, follow-up time, and lower educational level. Belonging to the GLADEL 2.0 cohort was protective against the occurrence of ESRD.ConclusionsPatients in the contemporary cohort benefited from advances in treatment strategies, with less cumulative damage and progression to ESRD, although mortality remained unchanged. These improvements likely reflect the increased use of newer therapies, more targeted approaches, in line with current treatment guidelines, and better access to specialized care.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"818-830"},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775501","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":"Bone microarchitecture impairment in juvenile systemic lupus erythematosus patients: A comparative study.","authors":"Beatriz D P Rosa, Erica M Barbosa, Melissa Mariti Fraga, Jade D Fernandez, Marcelo M Pinheiro, Maria T Terreri","doi":"10.1177/09612033261436510","DOIUrl":"10.1177/09612033261436510","url":null,"abstract":"<p><p><b>Background:</b> Juvenile Systemic Lupus Erythematosus (jSLE) is a multisystem inflammatory disease associated with bone loss. However, some patients experience fractures prior to the impairment of bone mineral density (BMD), suggesting that other bone microarchitectural properties, including the Trabecular Bone Score (TBS), may contribute to an increased risk of fragility fractures. <b>Purpose:</b> To assess TBS values in patients diagnosed with jSLE; to compare them with data from an age- and sex-matched sample of healthy individuals; to associate TBS with BMD values; and to evaluate the correlation between TBS and clinical risk factors, fractures, and BMD. <b>Research Design:</b> An observational, analytical, retrospective study. <b>Study Sample:</b> Patients with jSLE aged between 5 and 19 years. <b>Data Collection:</b> Clinical data and BMD values obtained by DXA between 2017 and 2022 at a quaternary care center were analysed. The BMD and TBS data were compared with existing published data from healthy Brazilian children and adolescents after age and sex matching. <b>Results:</b> Ninety-four examinations from 50 jSLE patients were analysed. Twenty-one (22.3%) examinations showed significantly lower TBS values than controls. TBS was lower in female patients aged 14-16 and 17-19 years compared with their peers (1.381 vs 1.466 and 1.397 vs 1.479, respectively). BMD and TBS were concordant in 80/94 (85.1%) examinations, demonstrating a moderate and positive correlation (<i>p</i> < 0.0001). There was no correlation between TBS and previous fractures, disease duration, high disease activity, cumulative glucocorticoid dose, or the presence of fragility fractures. <b>Conclusion:</b> Patients with jSLE exhibited bone microarchitectural impairment, regardless of previous fragility fractures, disease duration, disease activity, or cumulative glucocorticoid exposure.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"745-752"},"PeriodicalIF":1.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474112","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}